Consultant, Haemato-Oncology & BMT, Fortis Hospital, Shalimar Bagh, New Delhi
Part 7 of 8 in CAR-T Cell Therapy
The Cost and Availability of CAR-T Cell Therapy in India
September 6, 2026
CAR-T cell therapy is manufactured individually for every patient, which keeps it expensive wherever it is offered. Dr. Akash Khandelwal set out where India stands on cost, availability and upcoming trials.
Two products, more than a year of experience
Two CD19-targeted CAR-T products are commercially available in India today. NexCAR19, made by ImmunoACT, has been commercially available since December 2023, giving more than a year of real clinical experience with it. A second product was launched only about a month before this session and is still comparatively underutilised.
Among the most affordable CAR-T therapies in the world
Indian CAR-T is one of the most affordable versions of the therapy available anywhere in the world, though because each dose is still manufactured individually for the specific patient, it comes with a significant cost. Dr. Khandelwal expects that as more data accumulates and volumes grow, costs, potency and the overall risk profile will all continue to improve.
Trials underway, with a limitation for international patients
Fortis Shalimar Bagh is in talks to run its own CD19-directed CAR-T clinical trial for lymphoma and leukaemia, and other companies are working on myeloma CAR-T trials that are expected to bring a commercially available myeloma CAR-T to India by year end. One real limitation applies to international patients specifically: they cannot be enrolled in Phase 1 or Phase 2 trials, since these require longer follow-up before the Drugs Controller General of India approves long-term data for commercial or international use. Until a product clears that stage, the already-commercial CD19 CAR-T remains the only option available to patients coming from outside India.
This article is based on a Jivo Masterclass session conducted by Dr. Akash Khandelwal, Consultant, Haemato-Oncology & BMT, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Akash Khandelwal taught doctors across Africa on March 9, 2025.
FROM THE LIVE Q&A
Dr. Isaya Mhando (Tanzania)
What are the specific cancer cells targeted by CAR-T, and can it be applied to ovarian or cervical cancers?
Dr. Akash Khandelwal
Not yet - it hasn't shown good promise there so far. Currently CAR-T is only available for B-cells, targeting CD19, and this has shown long-term responses based on research done in the US, with a large subset of patients still in remission after CD19-targeted CAR-T infusion. Other categories are in development too, such as dual-target CARs and attachments that help CAR-T expand and persist for longer, but currently only CD19 CAR-T can be offered, since that's what's commercially available in India.
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Frequently Asked Questions
Where do you see CAR-T cell therapy heading in other cancers?▼
CAR-T cells are likely to become a first-line option in almost all cancers within the next 5 to 10 years. If it doesn't get there, that would actually be a missed opportunity, because it targets cells in a very different and unique way. More and more data is showing increasing promise for the treatment.
If possible, could you share your slides with us so we can go through the presentation again?▼
Yes, no problem: the slides will be shared after the session.
How many CAR-T cells are required per kilogram of body weight?▼
The cutoff is 5 million CAR-T cells required per kilogram of the patient's body weight.
For the approved indications of relapsed or refractory diffuse large B-cell lymphoma and B-cell ALL, patients need to be over 15 years old. What is the name of the CAR-T product available in India, so I can look up the clinical trial research myself?▼
There are two CAR-T products commercially available in India right now, both targeting CD19. One is NexCAR19, made by ImmunoACT, which has been commercially available in India since December 2023, so there is more than a year of experience with it. The second product was launched only about a month back and is still underutilised. Both target CD19, the marker responsible for the B-cell response, so B-cell ALL and B-cell lymphoma are the appropriate targets, not Burkitt lymphoma (the CAR-T construct needed is different) or CNS lymphoma (which does not respond as well).
I also attend a gene and cell therapy conference in Vietnam, and my institution is developing its own academic clinical trial in CAR-T. Are there upcoming CAR-T trial opportunities in India that international patients could join?▼
Fortis Shalimar Bagh is in talks to run its own CD19-directed CAR-T clinical trial for lymphoma and leukemia. Myeloma CAR-T trials are also upcoming from other companies and should be commercially available in India by year end. However, international patients cannot be enrolled in Phase 1 or Phase 2 trials, since these require longer follow-up before DCGI grants approval based on long-term data for commercial or international use. Until then, the CD19 CAR-T that is already commercially available is the only option for international patients.
Which CAR-T products are available in India?▼
Two CD19-targeted products: NexCAR19, made by ImmunoACT and commercially available since December 2023, and a second, more recently launched product.
Is CAR-T cell therapy affordable in India?▼
Indian CAR-T is among the most affordable versions of the therapy in the world, though it still carries a significant cost since each dose is manufactured individually for the patient.
Can international patients join CAR-T clinical trials in India?▼
Not in the early phases. Phase 1 and Phase 2 trials require longer follow-up before DCGI approval for commercial or international use, so international patients currently rely on the already-commercial CD19 CAR-T instead.
In This Series: CAR-T Cell Therapy
- 1.CAR-T Cell Therapy
- 2.What Is CAR-T Cell Therapy and How Does It Work?
- 3.The CAR-T Cell Therapy Timeline: From Collection to Infusion
- 4.Who Is Eligible for CAR-T Cell Therapy?
- 5.Managing Complications After CAR-T Cell Infusion
- 6.CAR-T Cell Therapy Outcomes: What the Data Shows
- 7.The Cost and Availability of CAR-T Cell Therapy in India
- 8.The Future of CAR-T Cell Therapy: Beyond Lymphoma and Leukaemia