MUMBAI: A quiet but significant revolution is transforming cancer care in India as immunotherapy—a sophisticated treatment previously restricted to the affluent—becomes increasingly accessible to the broader public. Over the past six months, oncologists across the country have reported a surge in prescriptions for this breakthrough therapy, fueled by the introduction of more affordable biosimilar versions of key medications.
For years, the high cost of immunotherapy served as a formidable barrier. In 2022, a study from the Tata Memorial Centre (TMC) revealed that a mere 2.8% of patients eligible for these life-saving treatments were actually receiving them. However, that landscape is shifting rapidly with the arrival of lower-cost versions of nivolumab, a potent drug effective against approximately 25 types of tumors and over 100 clinical indications.
Dr. Imran Shaikh, an oncologist at Kokilaben Dhirubhai Ambani Hospital, notes a marked change in clinical practice. “My prescriptions for nivolumab have risen by more than 50% in the last six months,” Dr. Shaikh told the Times of India. He explained that for patients who once balked at cycles costing over a lakh of rupees, the new price point of approximately Rs 30,000 has turned an unattainable luxury into a viable medical option.
The clinical benefits are profound. Dr. Kumar Prabhash, head of medical oncology at Tata Memorial Hospital, highlights that immunotherapy has fundamentally altered survival outcomes. For melanoma patients, long-term survival rates have climbed from a dismal 5% to 50%. Furthermore, for patients with specific forms of colorectal or lung cancer, immunotherapy offers a chance to avoid aggressive surgery or chemotherapy, allowing patients to preserve their quality of life and organ function.
Despite this progress, systemic challenges remain. Experts point out that India still lags behind global standards in the variety of available “checkpoint inhibitors,” offering only seven compared to the 35 available in markets like China. Additionally, there is concern that lower costs at the manufacturing level may not always reach the patient. K.M. Gopakumar of the Third World Network warned that hospitals maintaining their own pharmacies might be incentivized to stock costlier, high-margin original drugs rather than the more affordable biosimilars.
To address these disparities, the National Pharmaceutical Pricing Authority (NPPA) recently implemented a cap on trade margins for 137 anti-cancer medicines, effective November 8. This move is expected to save patients roughly Rs 2,500 crore annually. As four more versions of nivolumab prepare to enter the market—potentially pushing prices down to Rs 10,000 per cycle—the focus is now turning to ensuring these savings actually reach the patients.
Ultimately, medical professionals emphasize that while immunotherapy is not a “magic bullet” for every case, it represents a critical step toward equitable healthcare. As Dr. Jyoti Bajpai of Apollo Hospitals aptly noted, the true success of medical innovation lies not just in extending life, but in ensuring that such treatments are accessible to all, regardless of their financial status.
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