The study, published in the Head & Neck journal, compared the affordability of targeted and immunotherapy drugs across seven countries: India, Pakistan, Bangladesh, the US, UK, South Africa and China.qModern cancer medicines, particularly immunotherapy drugs for head and neck cancer, remain unaffordable for most patients in India and across the world, according to a new study led by the Tata Memorial Centre (TMC), Mumbai and the Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Navi Mumbai.The study, published in the Head & Neck journal, compared the affordability of targeted and immunotherapy drugs across seven countries: India, Pakistan, Bangladesh, the US, UK, South Africa and China. The Cancer Policy & Global Health, Kings Institute of Cancer Policy, London, UK, was part of the study.While immunotherapy drugs such as pembrolizumab and nivolumab have shown promise in extending survival for some patients with head and neck cancers, their costs are far beyond the reach of most families in these countries.Dr Arjun Singh, lead author from Tata Memorial Centre, explained, “Immunotherapy is not just expensive, it is completely out of reach for most families. In India, a six‑month course of treatment can cost more than several years of income. The problem is not medical progress, but drug prices that are far too high compared to the actual benefit intended.”Head and neck cancers are widespread in India, driven by tobacco, areca nut (supari), and alcohol. Most patients are diagnosed late, compelling families to pay out of their own pockets. Also, these immunotherapy drugs are not covered under Ayushman Bharat or other routine government health schemes.How prohibitive are costsAccording to the study, six months of pembrolizumab use in India costs nearly 80 times the average monthly income of the patient, while nivolumab costs more than 20 times. These figures are based on the maximum retail price (MRP) available in the market, with costs calculated for a six‑month therapy course. Similar patterns were seen in Pakistan and Bangladesh. Even in developed countries like the US and UK, these medicines are considered financially burdensome.A six‑month course of pembrolizumab (Keytruda) costs approximately ₹60–65 lakh, with a full year of treatment exceeding ₹1.2 crore, equal to nearly eight years of average Indian household income. A six‑month course of nivolumab (Opdivo) costs approximately ₹12–15 lakh.Story continues below this adBoth medicines are given as intravenous infusions in hospital settings, typically administered every two to six weeks depending on the regimen.What about alternatives?The researchers also found that the money needed to treat one patient with pembrolizumab in India could instead treat 18 to 22 patients with a lower-cost targeted therapy. While these cheaper medicines may not have the same efficacy as immunotherapy, they allow more patients to receive treatment when budgets are limited.Can biosimilars help?The study underscores major implications for India’s health system as Ayushman Bharat expands and cancer care grows. Despite customs duty cuts on cancer drugs, high‑cost therapies remain inaccessible without deeper pricing reforms. Researchers stress affordability as a marker of equity, urging stronger price negotiations, strict quality checks for generics and biosimilars, better insurance design, and greater focus on prevention and screening.They add that doctors must use costly medicines judiciously, backed by evidence, and call for research into contextual, cost‑effective options that Indian families can afford.Story continues below this adAs Dr Singh explains, “To make immunotherapy affordable, reforms such as medicare‑style central negotiations, capping price increases at inflation and faster approval of generics and biosimilars are needed. The patents of these two drugs would be expiring this year, so we are hopeful that biosimilars will soon become available at lower costs. National guidelines to prioritize which patients receive immunotherapy are needed. Innovative contextual drug regimens may also be very beneficial, rather than just maximum tolerated doses.”Senior author and Director at ACTREC, Dr Pankaj Chaturvedi, says, “When most people pay for treatment from their own pocket, such high costs can push families into poverty. Prevention, early detection and adequate and accessible treatment remain the most important ways to reduce deaths from head and neck cancer. Expensive drugs alone cannot solve the problem.” © The Indian Express Pvt LtdTags:Cancer