New Delhi: Cancer has emerged as one of the most financially draining health crises in India, with an increasing number of patients struggling to afford the exorbitant costs of treatment. The burden of cancer doesn’t just lie in the physical toll it takes on patients, but also in the overwhelming financial impact it has on families—often leading to debt, loss of savings, and even financial ruin.
With India seeing over 1.5 million new cancer cases annually, the cost of treatment continues to rise. Traditional cancer therapies, such as chemotherapy, radiation, and surgeries, can cost anywhere between Rs 2 to 10 lakh for a single cycle of treatment. For patients with aggressive or recurrent cancers, the costs can spiral out of control, making it almost impossible for many to continue with their treatment.
Expert oncologists inform that CAR-T cell therapy has proven to be a breakthrough in oncology, but its cost still remains a barrier to wider adoption. In India, the cost of treatment ranges from Rs 25 to 30 lakh (approximately $30,000), a fraction of the nearly $1 million price tag in Western countries. However, even at this reduced cost, affordability remains a major concern, limiting access for many patients.
Addressing how CAR-T Cell therapy balances the equilibrium of cancer care and cost, Dr. Rahul Purwar, Associate Professor at IIT Bombay, who designed and developed the NexCAR19, which subsequently underwent integrative process development and manufacturing under cGMP at ImmunoACT, said, “Since NexCAR19’s commercial approval in India, we have treated close to 300 patients. Initially, we treated about 10 patients a month, but that number has risen to nearly 30 patients per month. We have made significant progress in improving access, with over 50 hospitals now offering CAR-T treatment.”
“While the cost in India is substantially lower than in the West, it is still out of reach for many, particularly for lower-income families. The high cost, primarily driven by clinical development, quality assurance, and manufacturing logistics, remains a critical challenge,” Dr. Purwar further explains. “Manufacturing costs account for just 10–15 percent of the total expense, with the bulk of the costs tied to clinical and regulatory requirements.”
CAR-T Cell Therapy: A Beacon of Hope or a Costly Dream?
CAR-T (Chimeric Antigen Receptor T-cell) therapy, a cutting-edge immunotherapy, has garnered attention for its potential to treat cancers that have been resistant to conventional treatments. By genetically modifying a patient’s own T-cells to better recognize and destroy cancer cells, CAR-T therapy has shown remarkable results in blood cancers like leukemia and lymphoma. However, the question remains: Will CAR-T therapy, with its promise of a “magic wand” for cancer treatment, become a costly affair for most Indians?
Currently, CAR-T therapy costs anywhere between ₹25–30 lakh ($30,000–$35,000) per patient in India, making it unaffordable for many middle and lower-income families. Despite being significantly cheaper than its price in Western countries, the therapy’s high cost still places it out of reach for the majority of cancer patients in India.
One way to bring down the cost of CAR-T therapy is through centralized manufacturing, reiterates Dr. Purwar. He explains that the current manufacturing setup in Mumbai allows them to produce CAR-T cells for patients across India within 24 hours. This centralized approach helps ensure consistency and quality control, which fragmented regional manufacturing could not achieve. “We are developing a facility that can cater to 2,000 patients annually, which will bring down costs through economies of scale,” he says.
Dr. Dinesh Pendharkar, Director of Medical Oncology at Sarvodaya Hospital, suggests that government regulations supporting Good Manufacturing Practice (GMP)-certified manufacturing units could make outsourcing production more viable, further reducing costs and improving the speed of delivery.
Weighing the Cost vs. Benefit of CAR-T Therapy
The appeal of CAR-T therapy lies in its potential for long-term remission. Unlike traditional treatments, which often require repeated cycles over months or years, CAR-T therapy is typically administered as a single infusion. If successful, this could mean fewer hospital visits, reduced need for ongoing chemotherapy, and potentially a much better quality of life for patients. In the long run, CAR-T therapy might reduce the overall financial burden of cancer treatment, especially for patients suffering from aggressive cancers.
However, the upfront costs remain a significant obstacle. While traditional cancer therapies can sometimes stretch over several years, resulting in high cumulative costs, CAR-T’s price tag for a single treatment cycle is still prohibitive. For many families, this presents an impossible choice between life-saving therapy and financial devastation.
Moving CAR-T therapy from end-stage treatment to earlier lines in the treatment protocol could also enhance its cost-effectiveness, notes Dr.Hasmukh Jain, Professor of Medical Oncology at Tata Memorial Hospital, who added that for elderly patients with ALL (acute lymphoblastic leukemia), the current approach involving multiple rounds of chemotherapy is not only ineffective but also exhausting and costly. Replacing this with a one-time CAR-T infusion could reduce long-term healthcare costs while ensuring effective treatment.
Clinical trials are already exploring this shift, particularly for patients with aggressive forms of lymphoma, where early intervention with CAR-T therapy has shown promising results. The transition of CAR-T therapy from third-line treatment to second-line, and possibly even first-line, could lead to better outcomes and, importantly, reduce the overall treatment burden.
While CAR-T therapy is currently used primarily for hematological cancers, there is growing interest in expanding its applications to other conditions, such as autoimmune diseases. Dr. Esha Kaul, Director of Hematology at Max Super Specialty Hospital, highlights that therapies like rituximab began as cancer treatments and later expanded into broader applications. Similarly, CAR-T therapy could potentially see significant use in autoimmune conditions, which would help scale its production and reduce costs over time.
Dr. Kaul also emphasizes the importance of early adoption in treating high-risk patients with aggressive cancers like double-hit lymphomas. Early intervention can improve patient outcomes and prevent disease relapse, thus ensuring that the therapy delivers maximum benefit at a lower overall cost.
The Road to Affordable CAR-T Therapy in India
Reducing the cost of CAR-T therapy in India is a matter of scaling production, improving manufacturing processes, and leveraging local resources. One possible solution lies in centralized production, which could reduce the overall cost by allowing economies of scale. The development of domestic manufacturing capabilities for CAR-T therapy is one way to make it more affordable and accessible to a larger population.
Several Indian companies and healthcare institutions are already working on producing CAR-T therapies locally, and efforts are being made to improve the affordability of this promising treatment. With government support, regulatory changes, and technological advancements, there is hope that CAR-T therapy will become more accessible to Indian cancer patients in the coming years.
Dr. Pendharkar said, “Presently, we are talking of one company, one product. In years to come, we will have multiple companies, multiple products, and a huge demand. I personally feel that the government should come out with a regulation and allow companies to create GMP manufacturing units, multiple units. Then, the companies who are owners of the product can license their product for manufacturing to these GMP facilities. This would not only decentralize but also reduce the cost. It will increase the speed, as it will help in multiple CAR-T therapies coming in—not only for lymphoma and leukemia, but probably for many other cancers. So, we should be looking at a change in government regulations, creating GMP facilities for outsourced manufacturing of these products.”
Can CAR-T Be a Magic Wand for India’s Cancer Crisis?
Dr. Kaul mentioned, “CAR-T cell therapy is a true breakthrough. It offers a valuable tool for individualized patient care. While the technology is relatively new in India, the country has the expertise, talent, and mature transplant programs to lead advancements in CAR-T cell therapy. With regulatory support and responsible innovation, India can scale up CAR-T’s development and explore its applications in various fields. However, accelerating progress is essential to make this technology more accessible and impactful.”
Talking about the scope of CAR-T therapy and its benefits to patients, Dr. Jain said, “Currently, CAR-T cell therapy has changed the treatment paradigm in very specific groups of cancers, particularly acute lymphoblastic leukemia and lymphoma. There’s a lot of promise even in another disease, multiple myeloma, where, particularly in relapsed patients or those who have failed conventional therapies, the outcomes would otherwise be very poor. In these cases, CAR-T has definitely improved the outcomes, and there’s potential to cure a substantial proportion of those patients. This treatment is now moving into earlier lines of therapy, with trials even testing these therapies as frontline treatments. So, this treatment paradigm is set to change further.”
Dr. Vipul Sheth, Senior Consultant and Unit Head of Hemato Oncology and BMTU at Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), added, “The focus now is on improving persistence, as responses are no longer the sole measure of success. Advancements like armored CARs and improvements in manufacturing, patient selection, and pre/post-CAR management are critical. The ultimate goal is to extend CAR-T’s longevity and reduce the need for transplants, which carry risks like mortality.”
Meanwhile, Dr. Kaul reiterated that CAR-T is a true breakthrough, offering a valuable tool for individualized patient care. She said, “While the technology is relatively new in India, the country has the expertise, talent, and mature transplant programs to lead advancements in CAR-T cell therapy. With regulatory support and responsible innovation, India can scale up CAR-T’s development and explore its applications in various fields. However, accelerating progress is essential to make this technology more accessible and impactful.”
Dr. Purwar stated, “India is in the early stages of CAR-T adoption, taking ‘baby steps’ while working to improve every vertical, from product design to manufacturing, patient selection, and clinical delivery. Affordability remains the biggest challenge—current costs of ₹25–30 lakh make the therapy inaccessible to most. To truly expand access, efforts must focus on reducing costs so millions, rather than hundreds, can benefit from this transformative therapy.”
As the experts elaborated on how CAR-T therapy is evolving, the question remains: Will CAR-T cell therapy be a game-changer for cancer treatment in India, or will it continue to be a costly affair reserved for the privileged few? The promise of CAR-T is undeniable, offering new hope for patients who have exhausted all other treatment options. However, unless the costs are reduced and more patients can access the therapy, it may struggle to become the “magic wand” that the Indian cancer crisis desperately needs.
For CAR-T therapy to truly live up to its potential, it must evolve from a costly treatment to a widely accessible solution. The next few years will determine if this therapy can shift the balance between cost and treatment efficacy, giving millions of Indian cancer patients the hope they deserve.
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