ESMO 2026 | Developing strategies to make cancer medications more affordable

So, there are three or four things which are happening in the right direction and not only for my country, India, but I think for the whole world. The first is the development of biosimilars and generic drugs. Whether the world likes it or not, we are very, very proud of our pharmaceutical industry and the fact that they can give us as equi-effective alternative generic drugs which our patients can afford. This started with Glivac or Imatinib for sputonic myeloid leukemia. And now in India, we have generics for the checkpoint inhibitors also. We have generics for cituximab. So we are very satisfied on that front. Other than that, there are a lot of investigators in India which are now looking at new options. Like feel that the way the the the decided dose for these agents targeted therapies as well as immunotherapies is not correct we have followed the same module as which we follow for chemotherapeutic drugs when you’re doing the phase one study you find the maximum tolerated dose you go one level below that dose and that dose goes into the phase three trials and then into the approvals and the product inserts. Now the same thing doesn’t apply to targeted therapy drugs and to immunotherapy drugs. So more and more of us are convinced that the prescribed dose of immunotherapy and several targeted therapy molecules is not what is biologically needed by the tumor and needed by the patient. So, we are doing some high quality studies. There are some of our advanced centers, the Tata Memorial Cancer Center in Mumbai, the All India Institute of Medical Sciences in New Delhi, my own center at Jaipur, several other institutions in India which are doing these studies, publishing these studies and convincing the world that maybe one of the ways to cost reduce is to go down on the dose, go down on the duration and have the same effect. So that is something which we are very excited about. We have also invested particularly the Tata Memorial Hospital and the senior doctors over there in something which is known as oral metronomic chemotherapy. Small doses of oral drugs given over a prolonged period of time and sometimes continuously which works in a different way as compared to our weekly or three weekly big doses of chemo. And in certain tumors, it produces almost the same effects with very little toxicity. And we are also looking at, you know, reducing the duration of exposure. So, for example, you have to give a drug every week, what if you give it every two weeks? If you have to give it every three weeks, what if you give it every six weeks? So, those studies also we are doing. So, I am the president of the Indian Society of Oncology as of just now and as a society we have taken up this onus to take this initiative for innovations in expensive drug delivery, dosage, do more trials and you know, publish more papers on this.