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Cover Story

Deadly disease, killer costs

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Fifty-five-year-old Ramanand's (name changed) world came crashing down when he was diagnosed with blood cancer (leukaemia). A new wonder drug in the market could tackle his cancer at the genetic level with minimum side effects. But there was a catch: the drug cost Rs 1. 2 lakh a month - Rs 4, 000 for a single tablet to be taken daily. Not an option that Ramanand or 95 per cent of the Indian population can afford.

"Initially, for three months, I had to undergo traditional treatment and the side effects of that affected me so adversely that I could hardly sit up. If I had continued on that, it would only have been a matter of time before everything ended, as is the case for a lot of cancer patients, " says Ramanand.

Now on the new drug for over five years, he leads a nearnormal life. But he has been fortunate in more ways than one. A case challenging the company that held the patent to the live-saver led to licence for production of the drug being given to an Indian company, bringing down the price of treatment to a more affordable Rs 14, 000 per month.

"I could not have afforded even this reduced cost if my doctor had not got me on a programme under which I now receive the drug absolutely free of cost. If the Indian patent law had not made it possible for an Indian company to manufacture the drug cheaply, many of us would just have had to give up all hope, " says Ramanand.

According to some estimates, the market for cancer drugs in India is valued at about Rs 900 crore and is expected to cross Rs 3, 000 crore in the next five years, what with India's cancer population of more than 3. 5 million set to grow to a much larger number. The global oncology market, meanwhile, is currently valued at over $48 billion.

But it's a matter of conjecture - and concern - how a growing "cancer market" will affect prices. As of now, the situation remains bleak. People running trusts that offer financial assistance to persons diagnosed with cancer say they have lost count of the number of people who have been bankrupted from paying for the treatment of a loved one. And they are unanimous in identifying drugs as the most expensive part of cancer treatment, much more expensive than even the surgery or hospital stay.

Even in a government hospital where medicines might be free, the diagnostic procedures are not. "Patients have to undergo several CT scans and ultra sound scanning. Most of them come from far seeking treatment in big hospitals in the city. So they have the additional cost of stay, food, clothes and so on. We do our best to help them cope but the numbers are so high that our efforts seem like a drop in the ocean, " says Kiran Hukku of the Cancer Patients Aid Association, which offers help to the poor seeking treatment at Delhi's AIIMS.

"There are so many women who have to sell everything - house, land and even their mangalsutra - to pay for the treatment of their husband, " says Girija Sudheendran, who was so moved on seeing such impoverishment caused by the disease that she formed Sahaayika, a trust in Chennai that offers financial assistance to cancer patients.

Dr K Geetha, an oncosurgeon with the Max Group of Hospitals, speaks of the anguish of seeing patients drop out of treatment unable to afford the heavy costs. "We see so many such cases, " she says, adding that in many instances there is a second episode of cancer at another site in the body after the first successful treatment. "You can imagine what that could do to a family."

In India, still, for every single case that manages to get some financial assistance, there are hundreds forced to opt out of treatment, to just go home and wait for the inevitable.

rema.nagarajan@timesgroup.com

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