Search for cancer cure must not be hostage to Big Pharma

In recent years, immunotherapy has expanded the limits of cancer treatment. Therapies that harness the body’s immune system to fight malignant cells have improved survival rates in cancers once considered terminal. Yet, some of these breakthroughs, such as Merck & Co’s Keytruda, have also become a source of ethical unease. An investigation by this newspaper, in collaboration with the International Consortium of Investigative Journalists, reveals that the drug is priced beyond the reach of most patients. A 100 mg vial costs Rs 1.5 lakh and for most patients, therapy extends over months or years, taking the total cost into tens of lakhs. The medicine has become mired in a shadow economy. Across cities, networks involving hospital staff, pharmacists, and middlemen allegedly diverted used vials, refilled them with other substances and sold them as genuine doses at discounted rates. Patients, driven by desperation, have become easy targets of such illicit activity.

The investigation points to gaps in hospital waste disposal, weak tracking systems, and an absence of accountability in the drug supply chain. More fundamentally, it exposes how large pharmaceutical firms game the patent system. Merck holds the primary patent on pembrolizumab — the generic name for Keytruda — till 2028 and has built a dense “patent thicket” around it that includes protections over formulations, delivery mechanisms and incremental innovations. Such strategies are designed to delay the entry of cheaper alternatives even after the core patent expires. India has historically used its patent laws to curb such “evergreening”. Indian firms are now working on biosimilars of Keytruda that could reduce costs by as much as 70 per cent. But unlike conventional generics, biosimilars are derived from living cells rather than chemical synthesis. They demand advanced manufacturing capabilities, face stricter regulatory scrutiny, and can take four to eight times longer to develop. Courts have, by and large, prioritised patient access when cheaper substitutes are challenged by Big Pharma. Yet, legal battles can be protracted and critically ill patients do not have time.

Overall Analysis

The editorial examines the tension between medical innovation and accessibility, using cancer immunotherapy as a central example. It begins on a hopeful note, highlighting how advances in Immunotherapy have transformed cancer care by improving survival rates. However, this optimism is quickly contrasted with a critical perspective on affordability, particularly through the example of Keytruda developed by Merck & Co.. The sharp shift from scientific progress to ethical concern is a key stylistic feature — it underscores the paradox of life-saving innovation being inaccessible to many.

The editorial uses strong, evocative language such as “ethical unease” and “shadow economy” to highlight the darker consequences of high drug pricing. By describing illegal practices like refilling used vials, the author illustrates how desperation among patients can lead to exploitation. This narrative technique makes the issue more human and urgent, moving beyond abstract policy critique to real-world impact.

In the second paragraph, the tone becomes more technical and analytical. The editorial identifies systemic failures such as weak regulation and poor supply chain monitoring, but its deeper focus is on how pharmaceutical companies manipulate the patent system. Terms like “patent thicket” and “evergreening” are used to explain complex legal strategies in accessible language. The argument is that these practices delay the availability of affordable alternatives, prioritizing profit over public health.

The editorial also introduces a nuanced perspective by acknowledging the scientific and regulatory challenges of developing biosimilars. Unlike simple generics, these drugs are harder to produce and require more time, which justifies some delay but does not fully excuse prolonged monopolies. The mention of India’s legal and policy approach adds balance, showing that institutions have attempted to prioritize patient access, though legal processes remain slow.

Overall, the language combines emotional appeal with technical explanation. It criticizes corporate practices while maintaining an evidence-based tone, making the argument both persuasive and credible.

Important Vocabulary (5)

1. Malignant – harmful or cancerous in nature.
2. Illicit – illegal or not allowed by law.
3. Patent thicket – a dense web of overlapping patents used to block competition.
4. Evergreening – extending patent life through minor modifications to delay generic entry.
5. Protracted – lasting for a long time or longer than expected.

Conclusion & Tone

The editorial argues that while medical breakthroughs are crucial, their benefits must be accessible to all. It calls for stronger regulation, faster legal processes, and policies that prevent monopolistic practices by large pharmaceutical companies, ensuring that life-saving treatments are not limited to the wealthy.

Tone: Critical, concerned, and ethically driven — blending empathy for patients with strong critique of corporate and systemic failures.