After cancer, can biologics hold good for other diseases? How to rationalise cost of new therapies

This transformation is not confined to oncology. Patients with asthma, rheumatoid arthritis, inflammatory bowel disease and other autoimmune conditions now benefit from biologic therapies. Even some genetic disorders, once considered untreatable, are being addressed using advanced approaches such as gene therapy. Yet for most Indians, cancer and many other serious illnesses remain just as devastating and incurable as they were in the past.

The reason is access. Biological therapies are expensive, with treatment costs running into crores. For a majority of patients, these prices are out of reach. Treatment is delayed, interrupted, or never initiated at all, turning potentially curable diseases into fatal ones.

India’s pharmaceutical story makes this contrast especially stark. Over the past few decades, though the country has built a globally respected generic — drugs that are similar to biologic medicines — it has not kept pace. Biosimilars are not exact copies, because biologics themselves are large, complex molecules produced in living cells. But when developed and regulated rigorously, biosimilars offer the same clinical benefit as original biologics at significantly lower cost. They are the closest equivalent to generics in the biologics era, and they are essential if advanced therapies are to become widely accessible in a country like India.

This is the context in which the Union Budget’s Biopharma Shakti (Strategy for Healthcare Advancement through Knowledge, Technology and Innovation) initiative assumes importance. Biopharma Shakti represents a shift in India’s pharmaceutical ambition: from being primarily a global supplier of chemical generics to becoming a hub for biopharmaceutical manufacturing and innovation. Its focus on strengthening research institutions, expanding clinical trial capacity, upgrading regulatory expertise, and investing in complex manufacturing infrastructure directly addresses many of the structural barriers that have limited biosimilar development.

If implemented well, the potential gains are substantial. However, ambition alone will not be enough. Mission mode thinking, like how ISRO approaches space technology, will be required across a diverse set of stakeholders. Investment in skills and quality systems is more than investing in infrastructure. Biologics manufacturing tolerates little error and needs sustained emphasis on training and quality control at institutions that need to be prepared.

Finally, innovation must not be crowded out by cost-cutting alone. A successful biosimilar ecosystem should serve as a bridge from affordability today to original biologic innovation tomorrow. The science is ready. The necessary high-level policy choices have been made. What we need now are lower-level policy decisions that enable our ecosystem to execute. This ranges from ease of doing science at our research institutions to ease of doing business for our industry. Biopharma Shakti is a welcome announcement with a progressive vision but only the execution will decide whether advanced medicine remains a privilege or becomes a public good.

(Dr Anurag Agrawal is dean of the Trivedi School of Biosciences at Ashoka University)