Finance Minister Nirmala Sitharaman declared customs duty exemptions on three targeted cancer drugs: trastuzumab deruxtecan, osimertinib, and durvalumab during her Budget 2024-25 announcement.
Previously, these drugs carried a customs duty of around 10%. This decision aims to enhance the accessibility and affordability of crucial cancer treatments for Indian patients, thereby reducing the overall cost burden of cancer therapies.
Targeted cancer drugs are specialized treatments that selectively attack cancer cells while sparing normal cells. By focusing on specific genetic alterations in cancer cells that facilitate their growth and spread, these drugs offer improved outcomes and fewer side effects compared to traditional chemotherapy, which affects both healthy and cancerous cells. Newer therapies, such as immunotherapy, work by training the patient’s immune system to identify and attack cancer cells, rather than directly targeting the cancer.
Trastuzumab Deruxtecan Trastuzumab deruxtecan, marketed as Enhertu by AstraZeneca, is an antibody-drug conjugate used to treat cancers with the HER-2 receptor, particularly breast cancer. This drug is a second-line treatment for cancers that have metastasized or cannot be surgically removed. Initially approved for breast cancer in 2019, it has since gained approval for gastrointestinal cancers and received a "tissue-agnostic" designation from the US FDA in 2021, meaning it can treat any HER-2 positive cancer irrespective of its origin. The cost of this drug is approximately Rs 1.6 lakh per vial.
Osimertinib Osimertinib, commonly used in India and marketed as Tagrisso by AstraZeneca, targets lung cancers with epidermal growth factor receptors (EGFR). By blocking these receptors, osimertinib prevents cancer cell growth. It is used post-surgery or as a first-line treatment for metastasized cancers. Patients can take osimertinib until the cancer progresses again or severe toxicity occurs. Priced at Rs 1.5 lakh per strip of ten pills, osimertinib has shown significant survival benefits, particularly for non-smoking women, in whom EGFR mutations are prevalent.
Durvalumab Durvalumab, sold as Imfinzi, is an immunotherapy drug used to treat lung, biliary tract, bladder, and liver cancers. By attaching to PD-L1 proteins on cancer cells, it enables the immune system to recognize and destroy these cells. Studies indicate that durvalumab helps patients achieve longer remission and extended survival. The drug is priced at Rs 1.5 lakh per 10ml vial.
The removal of customs duties on these drugs is expected to significantly reduce the financial strain on cancer patients and their families. Even a modest decrease in price can provide substantial relief, allowing patients to allocate more resources towards nutrition, supplements, and other medical expenses such as tests and scans. Experts highlight that in India, approximately one lakh patients require these targeted therapies, which offer superior outcomes compared to traditional treatments.
The incidence of cancer in India is on the rise, with an estimated 14.6 lakh new cases detected in 2022, up from 14.2 lakh in 2021. Cancer-related deaths also increased to approximately 8.08 lakh in 2022. Women have a higher incidence rate of cancer compared to men, with the most common cancers among women being breast, cervix, ovary, uterus, and lung, while men predominantly suffer from lung, mouth, prostate, tongue, and stomach cancers.
The customs duty exemptions on trastuzumab deruxtecan, osimertinib, and durvalumab are poised to make a meaningful impact, particularly for treatments of lung and breast cancers, which are among the most prevalent cancers in India. According to the Indian Council of Medical Research, one in nine Indians will develop cancer in their lifetime, underscoring the critical need for accessible and affordable cancer therapies.