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Keytruda, also known as pembrolizumab, is transforming cancer treatment globally, but its high cost and limited accessibility raise serious concerns in India. Manufactured by Merck & Co., Keytruda belongs to a class of immunotherapy drugs called checkpoint inhibitors that enhance the body’s immune response against cancer cells. Unlike traditional treatments like chemotherapy and radiotherapy that directly attack cancer cells and often damage healthy tissues, immunotherapy works by reactivating the immune system. Keytruda blocks the PD-1 receptor on T-cells, preventing cancer cells from evading immune detection. This allows the immune system to effectively target and destroy tumors, especially in advanced stages of cancers such as lung, cervical, breast, and kidney cancer. Approved initially in 2014 by the US Food and Drug Administration, Keytruda has become one of the world’s best-selling cancer drugs, generating nearly $29.5 billion in revenue in 2024. However, its success also highlights a major gap between advanced medical innovation and affordability in developing countries like India. In India, Keytruda is available primarily in tertiary care hospitals, but the cost remains a significant barrier. A standard dose costs around ₹1.5 lakh per 100 mg vial, with monthly treatment expenses exceeding ₹3 lakh. Although patient assistance programs and government initiatives like customs duty exemptions have improved access, affordability remains limited for a majority of patients. The rising cancer burden in India further intensifies this challenge. According to estimates, cancer cases have increased significantly over the years and are expected to reach alarming levels by 2045. This creates an urgent need for advanced yet affordable treatment solutions. Another serious concern is the emergence of counterfeit versions of high-cost drugs like Keytruda. Fake medicines, sometimes indistinguishable from original packaging, pose severe risks, including treatment failure, health complications, and loss of trust in the healthcare system. This highlights the importance of strict regulatory mechanisms and safe procurement practices. While immunotherapy offers promising advantages such as targeted action and fewer side effects, it is not universally effective and remains financially inaccessible for many. Patent protection until 2028 prevents cheaper generic alternatives, but prices are expected to decline significantly after patent expiry. India is also exploring indigenous innovations like CAR-T cell therapies, including NexCar 19, to reduce dependency on expensive imported drugs and make advanced cancer care more accessible. Overall, Keytruda represents both a breakthrough in cancer treatment and a challenge in ensuring equitable healthcare access. Bridging this gap will require policy reforms, increased insurance coverage, domestic innovation, and stronger regulation of drug supply chains. #Keytruda #CancerTreatment #Immunotherapy #Pembrolizumab #HealthcareIndia #CancerAwareness #MedicalInnovation #UPSC #CurrentAffairs #Pharma #HealthPolicy #Biotechnology #AffordableHealthcare #CancerCare #IndiaHealthcare