Journalism of Courage
Cancer Calculus
Cancer Calculus, the investigation by The Indian Express in association with The International Consortium of Investigative Journalists (ICIJ), found a burgeoning black market in India of Keytruda -- -- an immunotherapy drug manufactured by US pharma major Merck & Co (MSD) that most families cannot afford at an official market price of over Rs 1.5 lakh for a 100 mg vial.
The Indian Express found that this counterfeit market was being fuelled by lack of access to the topline drug for most patients, and use of standardised high dosing that increases costs. It found hospital-level breaches and insider involvement, glaring loopholes in the system and how police investigators have unearthed evidence linking hospital staff to the counterfeit supply.
On a global level, the investigation by the ICIJ, of which The Indian Express is a part, reveals how one of the world's largest drugmakers deployed a number of tactics to both inflate the volume of prescriptions and keep the price high through lobbying and by seeking to keep cheaper versions of the drug from reaching thousands of cancer patients in the coming years.
The Indian Express found that this counterfeit market was being fuelled by lack of access to the topline drug for most patients, and use of standardised high dosing that increases costs. It found hospital-level breaches and insider involvement, glaring loopholes in the system and how police investigators have unearthed evidence linking hospital staff to the counterfeit supply.
On a global level, the investigation by the ICIJ, of which The Indian Express is a part, reveals how one of the world's largest drugmakers deployed a number of tactics to both inflate the volume of prescriptions and keep the price high through lobbying and by seeking to keep cheaper versions of the drug from reaching thousands of cancer patients in the coming years.
CANCER CALCULUS NEWS
7 Indian firms in race, experts eye cheaper Keytruda version in 2 years
April 16, 2026 11:44 am
To lower cost burden, oncologists suggest smaller doses, but Keytruda says no
April 15, 2026 11:14 pm
Keytruda was first approved by the US Food and Drug Administration (FDA) in 2014 for metastatic skin cancer and is now used across a host of cancers, raking in $29.5 billion in 2024.
Painful paperwork, Rs 10 lakh upfront: India’s cancer patients locked out of best-selling drug
April 15, 2026 11:11 pm
Globally approved for scores of cancers, the company's patient access programme in India supports it for 10 types of cancer, including specific forms of lung cancer, head and neck cancer, cervical cancer, renal cancer and melanoma.
Merck & CO on Keytruda leak: ‘Healthcare facilities responsible for used packaging’
April 15, 2026 11:14 pm
“Once a company product is delivered through the legitimate supply chain to a distributor, the company does not have visibility into how vials or packaging are handled after use. Disposal of used medicinal packaging is governed by local regulations and institutional procedures implemented by healthcare facilities,” it said.
Rs 1.5 lakh a shot, ‘magic’ cancer drug leaked from top hospitals, fakes sold to desperate patients
April 15, 2026 11:13 pm
How nexus of pharmacists and fixers uses authentic batch numbers and used vials of Merck & Co’s Keytruda; company says hospital’s responsibility.
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