The Cost of Cancer Treatment in India and How International Patients Are Supported

Previously it used to take 30 days, and it still does in most institutes, but with the advanced machines we now have, our turnaround time is only about five to six working days — even including a Sunday, a comprehensive NGS report is usually ready by about the seventh day.

The cost is very different for every cancer and every stage — it can vary from a few thousand rupees to a million rupees. The good news is that targeted therapy and immunotherapy drugs, which used to be very costly, now have more reasonable generic alternatives. For example, a drug that used to cost about $5,000 for a single dose as immunotherapy now costs just around $1,000 for a single dose. We also try to provide assistance programmes through indications approved by the companies that manufacture these drugs, to help patients financially.

It is not available for everyone blanketly — you first need to identify the target on the cell, which is where NGS and special staining come in. Not every individual harbours those targets, but many do, and we then use specific targeted drugs. Immunotherapy is not available for all cancers either, but with present indications it is available for the majority of advanced cancers — about 70% of advanced cancers would be candidates for some form of immunotherapy. There are specific criteria that must be met; giving it without meeting those criteria would not help the patient and would just be a financial waste.

We take a biopsy from the specimen, cut it into sections, make blocks, and apply immunohistochemistry staining, which lets us identify targets on the cells. We then do mutation testing to see what mutations are present in the genes, to identify further targets we can address. We also do PD-L1 testing, which tells us whether the patient can receive immunotherapy. It is a combination of these staining protocols along with NGS that tells us the best way forward for the patient.

We take the biopsy specimen and extract the DNA from the cancer cell, then sequence it to identify where something has gone wrong in the DNA or RNA, which tells us why that individual developed the cancer. Through this we identify specific mutations that may be the probable reason. Research is ongoing to counteract every change found on NGS, but currently we have a few drugs available for certain specific mutations — if we find one of those, we give that specific drug and the patient benefits.

Through ongoing collaboration between the local doctor and the treating specialist, including online case discussions for a nominal fee and, where needed, structured online consultations, so patients avoid routing through non-medical agents.

Because it helps patients understand their prognosis accurately and ensures continuity of care before and after any visit for treatment, rather than losing that continuity once a patient returns home.

Assistance programmes are available through drug manufacturers for eligible patients, helping make advanced treatment more financially viable as the price of newer targeted and immunotherapy drugs has fallen with the availability of generic versions.