Patent

Dealing with the cost of cancer treatment in India: Are patents the problem?


Image from here
Over the last several months, I’ve spent some time visiting some dear family friends who are undergoing treatment at a cancer hospital. This was the first time that I witnessed the disease and its treatment first-hand. Apart from putting life and the law in a new perspective, my occasional visits to the cancer hospital also served the purpose of researching the costs of cancer treatment in India, the manner in which Indians deal with the cost and the impact of patents on the overall cost of medical treatment. I thought it would be interesting to share some of the information/trends that I could identify/collect during my visits. 
A. Let’s start off with two case studies (What I remember from the conversations):
(i) Male Patient, 65 years, diagnosed with lung cancer with metastasis to the brain i.e. the cancer had spread to the brain at the time of diagnosis. Just the cost of diagnostics for this patient i.e. CT Scans, PET Scans, MRIs for the brain, FNAC, biopsy and other diagnostics came up to almost Rs. 1,00,000 (Rs. 1. Lakh). Post the diagnosis, the oncologist prescribed the following treatment: 6 cycles of chemotherapy + radiation for about 27-28 days. Each chemotherapy session, consisting of only generic medicines, cost up to Rs. 57,000 (approx.) plus there was the supportive medicine which is necessary for chemotherapy patients who usually suffer from an extremely low count of white blood cells as a result of the chemo drugs. In order to boost the WBC count, the oncologist had prescribed a dose of generic medicine (Peg-Grafeel) manufactured by Dr. Reddy, which was priced at around Rs. 8,800 (approx.) per dose. Therefore, each cycle of chemotherapy along with supporting medicine and diagnostics used to cost approximately Rs. 65,800. Six cycles would cost Rs. 3,94,800. The radiation therapy comes in different ‘packages’ depending on the side-effects. Together, the two cycles of radiation for this particular patient cost approximately Rs. 2,47,000. Therefore the total cost of the first battle with cancer was thus in the neighbourhood of approximately Rs. 6,41,800. 
 
Image from here.
(ii) Female patient, 60 years diagnosed with breast cancer confined to only one breast, with a previous history of breast cancer in the other breast. This time around the cancer was diagnosed as HER positive, a particular kind of cancer that can be treated quite effectively with Herceptin, a drug manufactured/marketed by Genetech/Roche and which has attained the reputation of a ‘wonder-drug’ in the field of cancer not only for its targeted action against cancer cells but also the lack of side-effects associated with conventional chemotherapy – namely lack of hair loss! Thanks to the invention of Herceptin, doctors predict that in the due course of events, HER+ breast cancer will witness a near cent percent success rate. That was the good news. The bad news is that Herceptin is probably one of the most expensive drugs in the world, costing approximately Rs. 1,10,000 for a vial of 440 mgs. Depending on the weight of the patient, the normal course prescribed is around 17-19 doses spread over a period of one year. Cumulatively that comes to around Rs.18,00,000-Rs.20,00,000 per patient. The first six doses of Herceptin are usually given in tandem with conventional chemotherapy – the TCH treatment – the conventional chemotherapy done with generic medicines is approximately Rs. 22,000. The six cycles of chemotherapy plus the peg-grafeel comes up to Rs. 1,80,000. Plus depending on the hospital that is treating you, there may be the added ‘chemotherapy charges’ which is levied by the hospital at rates ranging between 8% to 12% of the total cost of the pharmacy bill. When being treated with Herceptin, that 12% can add more than Rs. 10,000 to your bill. I think it is an unfair practice but then again who are you going to complain to? Added to the cost of chemotherapy is radiation, which can range between Rs. 150,000 to Rs. 275,000 depending on the package. Cumulatively therefore, the cost of the treatment can cost approximately Rs. 20,00,000 to Rs. 22,00,000. 
B. The Analysis: The reflex reaction of most people to the above figures will involve first cursing cancer, then cursing god & karma, followed by cursing the pharmaceutical companies and lastly the government. The ‘glass-is-half-full’ types are more likely to thank god, the doctors, the pharmaceutical companies etc. for helping them in fighting the disease and who knows, even winning against it. Moving on to some of the interesting trends/analysis that I could identify: 
 
(i) Patents & Biologics: Unlike the other anti-cancer drugs, such as Tarceva & Nexavar, which have recently been in the news for patent battles, Herceptin, to the best of my knowledge is not yet patented in India. You would think that without a patent and a promise of a huge margin even for a generic version, Indian pharmaceutical companies would be lining up to mass-produce Herceptin. Do you know how many generic versions of Herceptin are available in the market? None! Cipla has promised to come out with a generic version in a few years but what’s been holding back Indian companies for the last two decades. Given that the European patents on Herceptin are set to expire sometime around 2015, it would mean that the technology has been in the market for around 17-18 years. 
 
Herceptin, like Pegasus an earlier drug that we discussed on this blog, are both biologics, a class of drugs distinct from the conventional chemistry based drugs. Therefore despite Indian companies technically having the opportunity to manufacture both Herceptin and Pegasus (under CL provisions) not a single company has forayed into the field. I’m not sure whether this is happening because of a lack of a transparent regulatory structure for bio-similars or because of a lack of technical expertise in Indian companies. Companies like Dr. Reddy’s do manufacture some biologics like Reditux and peg-grafeel, so clearly, there is some expertise in the field but not enough to manufacture a more complicated drug like Herceptin. 
 
Image from here.
What makes the matter even more interesting is the fact, that unlike Tarceva and Nexavar [both of which are patented and infringed (by Natco, Cipla) in India] Herceptin is a drug approved by the National Institute of Clinical Excellence (NICE) for purchase by the National Health Service (NHS) in the United Kingdom (U.K.). Any drug approved by NICE is worth its weight in gold and is indicative of the therapeutic potential of the drug vis-à-vis the cost of the drug. The estimated revenues of Roche from worldwide sales of Herceptin are in the neighbourhood of $ 3.4 billion dollars. 
(ii) ‘Per capita’ income: India’s per capita income for the last financial year was reportedly at around Rs. 50,000 per year (subject to certain riders). I’m not sure at how the government calculates the income of the ‘middle class’ but for the sake of this post let’s presume that it is 10 times the per-capita income at around Rs. 500,000. As I discussed above, the treatment of the male patient with lung cancer, even with generic medicines, came up to Rs. 6,41,800. Therefore, forget the poor citizen, even a middle class citizen of this country is unlikely to be able to fund his cancer treatment, even with generic medicines, just out of his pocket. The most certain retort to this argument would be that even developed countries are able to pay for expensive cancer treatment only through private insurance or public funded health programs.
(iii) Insurance policies: In the last few years there has no doubt been an explosion in the health insurance market. The problem however, as I understand, is the near abysmal knowledge amongst Indians about the cost of modern medical treatment. Sample this – I just did a random survey, amongst people I met, on the insurance coverage that they had taken and the highest insurance coverage that I got was Rs. 4,00,000 and the lowest – Rs. 1,00,000. Even the maximum insurance coverage of Rs. 4,00,000, would not be able to meet the cancer costs of the first patient discussed in the beginning of this post. All the people that I spoke to were actually upper middle class and they had the financial capacity to subscribe for higher insurance premiums but didn’t do so because they simply had no idea of the cost of any potential treatment, not just cancer treatment. Apparently the insurance salesmen themselves had no clue.
Therefore I’m very curious to know as to why exactly ‘big-pharma’ is under the impression that increasing insurance coverage and rising incomes in India make it a lucrative market for even patented drugs. From what I understand insurance coverage in India, in terms of value, is pathetic. At the very least pharmaceutical companies, be it generic of innovator, should seriously start educating insurance companies on the actual cost of treatment because as things stand now the insurance sector doesn’t seem to have a clue on actual costs. Ultimately it is pharma companies which have the most to benefit from such increased coverage.
(iv) Differential pricing: One of the problems with new medicines introduced by big-pharma in the Indian market is that they are usually sold at the same cost through the world market. Therefore if the drug is sold at $40,000 dollars in the U.S., that same drug will be sold at the same price in the Indian market despite the huge difference in per-capita incomes in both countries. In the last few years several big-pharma companies have started a differential pricing scheme for the Indian market because it is quite clear that Indians simply cannot afford to pay the same rates as in developed markets. The only price-cuts I’ve heard of in the cancer segment are by Glaxo-Smith-Kline. Apparently the price-cuts were as steep as 70% when compared to the prices in the U.S. One such interesting product is Tykerb. For a year of treatment in India Tykerb costs Rs. 6,00,000. Contrast this to the cost in the U.K. which in 2009 was at 25,000 pounds. As noted by GSK in one of its investor documents, the price reduction of Tykerb in India literally doubled the sales of the product. Roche has promised to slash the cost of Herceptin in the next two years. 
What I found more interesting however was the competition between Herceptin & Tykerb. Like Herceptin, even Tykerb targets the HER mutation in breast cancer patients and although it not reported to be as effective as Herceptin, it does seem to have a decent success rate. Now although Herceptin is known to be more effective than Tykerb, when offered a choice by oncologists breast cancer patients with Stage I cancer (which is painless) will opt for Tykerb simply because of the huge price differential. After all it is Rs. 600,000 v. Rs. 18,00,000 for Herceptin. I’m not even sure whether Tykerb has received clinical approval for Stage I treatment but I’ve heard that it is being offered for even Stage I breast cancer patients.
As far as I know, GSK has a patent for Tykerb in India and the patent has not yet been infringed by any of the generic companies which have otherwise busted every other patent for cancer drugs. As far as the reported news goes Cipla has only filed a post-grant opposition against the Tykerb patent. So are price-cuts the solution to competition from generic pharmaceuticals?
(v) Government spending on cancer treatment: So far, most of this discussion has revolved around the middle class. What then happens to the poor? Honestly and I’m ashamed to say this – I just don’t know. I have heard of a story of poor patients being given excellent and more importantly free cancer treatment at one of the leading government hospitals in Chennai. I however have no idea of the remaining government hospitals. I’m guessing a lot of other government hospitals do offer cancer treatment. Apart from these hospitals and charitable organizations, I don’t think poor cancer patients have any other option for treatment in India. Some State Governments do offer insurance coverage even to the poor but it is unlikely that so schemes will suffice for cancer treatment. Unfortunately, the Central Government does not seem to have any strategy to deal with the rising cases of cancer treatment. At least for TB and HIV, the central government has some kind of public funded programs in place such as NACO etc. Cancer unfortunately has simply dropped off the map. Once again, it is the pharmaceutical company which should take the initiative to lobby with the Central Government for creating a public funded program to assist in the treatment of cancer. In terms of profits, these companies are sitting on a virtual goldmine.
(vi) Price-Control: India’s experiment with price-control for drugs has been largely ineffectual either due to poorly drafted laws or due to poor implementation. Moreover patented drugs are not covered under the present price-control regime. In its 58th Report, the Parliamentary Standing Committee on Health and Family Welfare had this to say on price-control for patented medicines: 
The Committee notes that as of now there is no mechanism in place to regulate the prices of new patented drugs which are imported in the country and sold at supernormal profits, whereas prices of the same medicines are considerably lower in other countries. The Committee does not accept the submission made by the Secretary (Pharmaceuticals) that there is no price control of a patented drug for open market. The Committee would like to observe that India as a sovereign country has every right to decide the prices of a drugs which are sold in the open market. The Committee therefore recommends to evolve an effective mechanism to control prices of imported patented drugs being sold in Indian Market.
It would be interesting to see the government experiment with price-control on patented drugs. In many ways, such price-control measures will automatically resolve the ‘differential pricing’ dilemma being faced by innovator pharmaceutical companies. However given India’s history with price-control, I wouldn’t bet on this option. 
 
Conclusion: I’m aware that this post may seem to be a bit random but I thought it would be interesting to start a conversation on the more practical aspects of dealing with the cost of treating cancer. In 2010 alone, India lost a total of 556,400 citizens to cancer. A detailed study published in the Lancet, available over here, documents trends and patterns in these deaths. Later studies have estimated that by 2030, cancer cases will rise by 70% in India. Even in its peak years, the deaths from AIDS/HIV at 400,000 citizens were substantially lower than the present number of cancer deaths. In 2009 after years of sustained intervention the HIV/AIDS mortality figure dropped to 172,000. Thanks to the activism surrounding AIDS/HIV, the government at least created the National Aids Control Organization (NACO) to co-ordinate a response to the epidemic. Although the program does face its challenges, it has helped in curtailing the spread of the HIV virus. Unfortunately, there seems to be little in the way of a co-ordinated government strategy to deal with the issue of cancer treatment. There has been some talk of universal health coverage for all Indians but that plan is still only on paper. Regardless of universal health coverage, cancer is a disease very distinct from other diseases and it needs a separate solution. More often than not the healthcare debate gets completely hijacked by the issue pharma patents. It is time we begin to focus on the main issues at hand.
Prashant Reddy

Prashant Reddy

T. Prashant Reddy graduated from the National Law School of India University, Bangalore, with a B.A.LLB (Hons.) degree in 2008. He later graduated with a LLM degree (Law, Science & Technology) from the Stanford Law School in 2013. Prashant has worked with law firms in Delhi and in academia in India and Singapore. He is also co-author of the book Create, Copy, Disrupt: India’s Intellectual Property Dilemmas (OUP). He has recently been appointed as an Assistant Professor at NALSAR, Hyderabad, starting September 1, 2017.

29 comments.

  1. Hasan

    Thanks for writing this interesting piece. I think patents are just another barrier and that is too in specific situations and of course when this barrier is there it should be overcome through compulsory licence etc. Focusing on CL debate in the context of recently issued CL in India does not mean that we should ignore other factors like lack of any coordinated efforts and policy on the part of government to address this problem etc. You mentioned about biologicals and associated problem of regulatory approval of biosimilars. India does not have any clear guidelines of policy in this regard and we need to put one asap. But having such a regulatory framework may not help you unless there is sufficient “market” for a drug yielding good returns to generic companies. After all it is a business for them and this segment does not have additional external incentives which HIV/AIDS drug have in terms of bigger market and donors’ money. Unless a bigger push comes internationally to provide treatment for non communicable diseases, Indian companies will not come forward to divert resources towards production of such medicines.

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  2. Rajiv Kr. Choudhry

    The situation in India is probably unique in the world and has its own challenges. It is a fact that none of the drugs in the list of essential drugs list are patented in India, i.e. there is no interfering part played by patents.

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  3. Anonymous

    I dont agree with the comparison made with TB or HIV. The deaths due to infectious diseases such as these are any time higher in a country like India. See http://www.worldlifeexpectancy.com/world-rankings-total-deaths.

    The issue of cancer drugs and why generics don’t want to make copycat versions is serious one and interesting.

    I totally agree with Hasan that the drugs like Herceptin doesnt have enough market and thus it is priced at a higher rate in other countries too unaffordable by the lower strata group.

    Further in the battle of generics one tends to forget the amount of money and sweat any company invests in a drug. With barriers like compulsory licensing and section 3d no innovative drug will ever enter the Indian market unless we innovate ourselves. Isnt it interesting to note that we really dont have any.

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  4. Anonymous

    For what it’s worth, here is the cost of treatment for her2+ breast cancer in US.
    19k usd per cycle of TCH + Neulasta.
    I f you have decent insurance, out of hand would be 10 to 20% of the total cost

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  5. Zaman

    You have forgot to add that there are generic cancer medicines at dirt cheap prices in India. Cipla is one such generic supplier which provides significantly cheap cancer drugs and has been continuously reducing the price of generic cancer drugs from his company. Cipla’s owner Yusuf Hamied has promised to reduce it even further. Indian people should also trust in Indian companies such as Cipla instead of going after foreign ones which are upto a hundred times more expensive. The whole of Africa and the underdeveloped world uses HIV and cancer drugs from Indian companies such as Cipla. There are more than 7 million users of HIV drugs now in Africa after Cipla took on the major pharma companies of the West and produced a generic at dirt cheap price 10 years ago. Only 2000 patients could afford the same HIV drug back then. I am not saying that Indian companies generics might be as good as a Western drug launched just a year ago. But still they are far better than going with no treatment.

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  6. naren

    Human right for older women of 68 years in India to survive.

    I am now 67 and has been down with cancer since Feb 2012. I have also lost my voice and hearing besides I have high sugar. My husband managed my treatment of operation, chemotherapy and radiation till date by mobilizing all his savings but still I am not ok, cancer has sped in bones and lunch .
    It has become impossible for him to support my second course treatment with no income except some house rent just sufficient for our two squire meals.

    He approached the Ministry of social justice and Empowerment as senior Citizen in July 2012, for releasing our pay revision arrears of 1992, but all appeared to be of no use rather they were kidding with him when I am dying with cancer for not having proper treatment.

    After many reminders he received the copy of the letter No F.No.15-39/ (13)/2011-12/AG on Aug end, from Ministry of Social Justice and Empowerment (Aging Section) posted on July 12 2012 signed by one Mr. J.K.SAHU, Under Secretary of the Department address to The Secretary, Social Welfare Department, and Govt. Of West Bengal Kolkata for financial assistance for medical treatment received through PM’s Office vide letter No 11/3/2012-PMP2/406212 dated 16/7/12.

    It appeared to us ridiculous that in place of releasing his due or extending help from PM’s relief fund asking Govt. of West Bengal for financial help.

    The Addl. Private Secretary of Chief Minister’s Secretariat also had asked for some ritual detail like monthly income of me who had never worked, as well as Certificates and. recommendations of MLA/MP’s on 31/10/12.

    Being a non political invalid person of 76, it is impossible for him to get certificate and recommendations required for financial help from Govt. of WB.Chief Minister’s relief fund which is for more needy persons of west Bengal which is most deprived state, when his own money of pay revision arrears of 1992 has been mis managed by the then representatives of Ministry of Heavy Industries/ BBUNL in the process of divestment of PSU for favoring the purchaser for their own material gain.

    When no positive reply received from the Deptt. he finally appealed to PM as well as President of India for this amount which is only to be used for my treatment for little comfort for my remaining days which is very shot .

    Since it is delicate for the Govt. to open the issue he requested them to kindly help him to get financial help from PM’s relief fund or any relief fund of Govt. of India where he worked for 26years to the extend of his legal due for me only l which may be recovered from Ministry of HI/ BBUNL/ LJMC. in due course of time, in place of asking Govt. of WB.

    This is my request to Human Right Commissioner in view of cancer has sped to my bone skull and even lunch ( copy of last report will be sent if required)to help him to get the arrears amount from Govt. to treat myself for his satisfaction .

    If there is any Human right to save me in his situation by relishing our dues, please do it immediately or blankly say “you die with your fate”

    Respectfully,

    Lina Hazra
    BG 124 Salt Lake Kolkata 700091
    E Mail [email protected]

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  7. Malvin Brook

    The country has emerged as the ultimate destination for all surgical related treatment and Oncology Surgery India draws in patients from far fledged countries like Nigeria. It is the facilities along with the state of art infrastructure which are the focal points for this industry. Normally cancer happens to be a complicated procedure and the risk factor is on the higher side but in the case of Cancer treatment India one can be assured of the best in treatment.

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    1. Narendra Nath Hazra

      It is fact cancer treatment is not bad in India specially if it is in Tata medical center Kolkata ,But you need continuous supply of funds where you can not wait . Hospital had done what as possible i also tried to reduce the price of the chemo drug with the help of the supplier but it was for the Ministry of Heavy Industries and the then PM who perhaps wanted to see that my wife dies as early as possible and my case with is with Supreme court is not being pursued for helping their own agents..

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  8. Vishal

    Absolutely agree on the complete lack of proper coverage available from insurers. 4 to 5L is not going to cover your cancer costs and often these medicines do not require hospitalization – so there’s that catch too as most policies cover in case of hospitalization for a minimum of 24 hours. The insurance sector in India is a joke!

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  9. www.cancermedicineindia.in

    Friends, it has been surely because of people like you that a serious debate has started regarding prices of drugs. Our close competitor China is in no way near to us regarding the step of Compulsory Licence being granted in our country. But I feel there is always a large scope of improvement.
    Most importantly, the foremost cause of Cancer, tobacco, must be banned according to me. Charging high taxes and then spending it on health programs does not nullify each other. The major inequality that remains in this equation is the suffering, pain and fear.
    My Little Part:
    Talking about medicines, actually Cancer medicines cost much less if bought from the right source. We have always been a supporter of reducing the huge gap between MRP and distributor price so that patients may not be exploited by anyone(institutions or individuals alike). We are distributors for all kinds of cancer therapies available in India and that is the reason we know this. There are also a number of relatively cheaper substitutes available.
    Our website: http://www.cancermedicineindia.in
    Email id: [email protected]

    If you feel that we may be of help to anyone, please do you Little Part…. 🙂

    Reply
  10. Anon

    Roche abandoned their Herceptin patent. Then blocked the sale of a generic version of Herceptin developed by Biocon, by filing a suit. As for your question of generics in biologics. India doesn’t as ‘yet’ have the capability to reverse engineer biologics in nearly the same capacity as chemical biologics. We will get there in another ten years if the present IP regime remains. We will probably lose out to Israel if we change our IP regime.

    Biocon was working on a generic version since 2009. So, there are companies working on biologics. They need at least five to six years to get to a biologic patent. Even in the US biologics are protected for only ten years. So not sure why that isn’t part of the article.

    Roche played dirty to keep the generic off the market in February 2014.

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    1. SBR

      It’s really heratening to note that there are voices which support the development of the generic versions of Herceptin that has been jointly developed by Biocon and Mylan. But sadly, the law does not see the good that such a drug product can do to the people suffering from the cursed disease and instead chooses to decide in favour of a company that clearly has only “profits” in mind rather than good of mankind.

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  11. Riddhi Talwar

    Since the discussion is about the rocketing high cost of cancer treatment in India, what I want to add in that is this is one more reason why people are getting inclined towards the Alternative Therapies like Immunotherapy. This alternative therapies also help a lot in coping with the ever increasing cancer patients with a fast rate. One hospital I know in India which is practicing chemotherapy is Cancer Healer Center.

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  12. kumar

    However, it is tough to fight with cancer. Especially, it is a great task to find the best cancer hospital in India. Hospitals like KIDWAI in bangalore, and Arignar Anna Cancer Instiute in KANCHI hospitals are doing their good in providing the best treatment for cancer patients at affordable prices.

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  13. Nitinkumar Warwade

    Respected Mam & Sir,
    I am a Professor of Engg. College & I would like to inform you that I have a safe Ayurvedic Treatment for any type & stage of Cancer & other disease. And now I have decided to spend my remaining life for the mankind. Consequently I am requesting to all of you that if the present cancer treatment is not giving help to the present patient then I can help to those patient free of cost ( Except the Ayurvedic Medicine according to condition)
    Hence this information.
    Thanking You.
    Prof. Nitinkumar Warwade

    Reply
    1. Deepak

      Dear Nitin,

      I am Deepak Sharma from Haryana. My father is suffering from pain in his wright wing from last 3 months. We have done some check-up in one hospital in Delhi. Doctors declared cancers in his right lung after several tests like PET-CT/ CT guided biopsy.

      Doctors advise for Chemotherapy and radiation treatments. All these treatments costs will be around 4-5 Lacs, which I am unable to afford. Also, my father is not much strong to tolerate these treatments. These treatments have side effects too.

      You are telling some Ayurvedic treatment’s. I want to know in detail about these Ayurvedic treatments.

      Could you please provide me some more information regarding these treatment’s.

      Your help will be much appreciated.

      E-mail ID: [email protected]

      Thanks and regards
      Deepak

      Reply
    2. Somnath Mali

      Dear sir ,
      I am somnath Mali from Latur ( Maharashtra) , just before 2 days we came to know my uncle is having right lung cancer , requesting you to plz guide and give detail information about how to contact you .

      Reply
    3. fatima

      SIR,… MY UNCLE AGED AROUND 65 YEARS IS RECENTLY diagnosed with lung cancer stage 4.Kindly guide me what can i do to help hm as they cant afford the costly treatment.

      Reply
  14. Githinji

    i think India has the best cancer care and relatively cheap assuming that is what makes people run to India..how ever….the government should make this treatment for affordable to the less fortunate. cancer has become worse than AIDS.

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  15. Narendra Nath Hazra

    As it is what i feel 99% cancer patienst dies after prolonged treatment, which is normally very expensive and most of the cases family also come to road to manage the same .so the Govt. attitude to make a show as was done by the then UPA Govt. can not be discouraged. Rather Govt. should have a clear policy in this matter. Fact of life what i have seen in my life when my wife was suffering in cancer , for one chemo drug Ixempra/zoledromic which was costing about a lack and in the course six to be taken . i could some how manage four and could not arrange the remaining. I appealed to the then PM and President of India to loan me the amount required as loan from my due arrears of 1992, during 2013 ,but they never bother rather took some course which was never expected from the Cong Govt. Ultimate ly she died on Nev 13. leaving me alone at 80 only to pray some thing befitting for them. To day with one word pay hike is there for useless people where as needy people would not get any thing , except sermons ” intolerance”

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  16. sanjay

    If you could identify cancer in it’s beginning stages, then you could go the alternatives like ayurvedic treatment. These are proved to be the best and less expensive. Again, this works only if you can identify cancer in it’s starting stages.

    Reply
  17. physiotherapist in BTM layout

    All the people that I spoke to were actually upper middle class and they had the financial capacity to subscribe for higher insurance premiums but didn’t do so because they simply had no idea of the cost of any potential treatment, not just cancer treatment. Apparently the insurance salesmen themselves had no clue.

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  18. Sudhakar reddy. K

    United India insurance co Ltd ,Good health TPA services Ltd not clearing adjuvant chemotherapy 2 nd cycle bill claiming that chemotherapy is allowed but not adjuvant chemotherapy. My wife was detected DCIS in 2011 by mammography ,underwent surgery , radiation and harmonal therapy at Apollo hospital ,Hyderabad, Recently a lump developed in same breast was removed by Radical Masectomy and suggested chemotherapy . Insurance company paid for surgery and 1st chemo therapy through chemoport but refusing to pay for 2 nd chemo was given on 12/05/17.. Being a Retired Professor, pensioner I can afford treatment but what about common man. Surgery fallowed by chemo therapy is part of treatment , that they consider it as adjuvant chemo and refusing,it is absurd and un ethical .
    Insurance companies should extend coverage to adjuvant chemo also.

    Reply

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