Dr. Deepak Koppaka, Senior Consultant Medical Oncologist at CARE Hospitals, Hi-tech City, Hyderabad, brings deep expertise in precision oncology and affordable cancer care. With training from reputed institutions and a strong commitment to patient-centred treatment, Dr. Koppaka is at the forefront of advancing access to novel cancer therapies in India. In conversation with Rashmi Kumari of Neo Science Hub, he discusses the impact of tax cuts on life-saving drugs, the challenges of affordability, the gaps in diagnostic infrastructure, and his vision for building a more equitable and accessible cancer care system across both urban and rural India.
How important are Trastuzumab Deruxtecan, Osimertinib, and Durvalumab in cancer treatment today? Who are they usually given to?
Trastuzumab Deruxtecan, Osimertinib, and Durvalumab are important medicines used in cancer treatment today. Trastuzumab Deruxtecan is mainly for breast cancer patients who have a type called HER2-positive. Osimertinib is used for lung cancer patients who have a specific gene change called EGFR mutation. Durvalumab is for lung cancer patients, usually after they’ve had chemotherapy and radiation. These drugs help patients live longer and feel better during treatment.
After the tax cut, have more patients been able to afford these drugs?
Yes, we are seeing more patients considering these medicines because of the tax cut. The change hasn’t been huge yet, but some patients who couldn’t afford these drugs before are now looking into them. We expect more patients to be able to afford them in the future.
Are these drugs affordable for the average Indian patient now?
Even after the tax cut, these drugs are still expensive for many people. They are a little easier to afford than before, but for most patients, it’s still a big financial burden. Some patients with insurance or outside help may be able to manage the cost, but many still struggle.
Are the tests needed before using these drugs (like HER2, EGFR, PD-L1) easily available in smaller towns or villages?
No, many smaller towns and villages don’t have the facilities to do these tests. Without these tests, doctors can’t decide if a patient should be treated with these drugs. Even if the medicines become cheaper, without the tests, patients can’t benefit from them.
Have hospitals and pharmacies started charging the new lower prices?
In some places, hospitals and pharmacies have started charging the new lower prices, but there are delays in others. Some are still waiting for updated prices from suppliers. Hopefully, all hospitals and pharmacies will adjust the prices soon.
Do insurance companies cover these medicines? What needs to improve?
Most private insurance plans don’t fully cover these drugs or have limits. Government insurance schemes, like PM-JAY, usually don’t cover them at all. To improve, insurance companies need to cover these drugs better and offer higher coverage, so more patients can benefit.
Besides price cuts, what else should be improved to make cancer treatment more accessible?
We need better hospitals in smaller cities, cheaper tests, more trained cancer doctors, and extra support for poorer patients. These changes together will make cancer treatment more accessible to everyone.
Should the government also reduce taxes on other cancer medicines, especially generic ones made in India?
Yes, lowering taxes on generic cancer drugs made in India would help more patients afford them. Many Indian-made cancer drugs are already cheaper, and if taxes are reduced, even more patients could benefit.
Should these drugs be added to the National List of Essential Medicines or be price-controlled by the government?
Yes, if these drugs are added to the National List of Essential Medicines (NLEM), it would help make them more affordable. The government could also negotiate prices to make them cheaper, but it’s important to make sure companies can still develop new medicines.
Do you think this policy could create a bigger gap between patients in metro and non-metro areas? How can we fix that?
Yes, there’s a risk that patients in metro cities will benefit more from these changes because they have better access to healthcare. To fix this, we need to improve healthcare in smaller towns, more labs, trained doctors, and better awareness in these areas.
Can you share an example where a patient could or couldn’t get these drugs because of cost? Did the price cut help?
I had a breast cancer patient who couldn’t afford Trastuzumab Deruxtecan before. After the price cut, the drug became a little cheaper. With help from NGOs, she might now be able to start treatment. It’s not a huge difference, but it’s giving us hope that more patients can get these treatments.
What does “affordable cancer care” mean in India? How close are we to that goal?
Affordable cancer care means that everyone, whether rich or poor, should be able to get the treatment they need without going broke. We are making progress, but there’s still a long way to go. The recent price cuts are a step in the right direction, but we need more changes to make treatment affordable for all.
