At Scale-Up Health, an initiative by Eight Roads Ventures, industry leaders highlighted that the challenge is no longer scientific capability but rather access, financing, and delivery models while discussing on the road to India’s first billion-dollar drug.
The panelists Amit Mookim, CEO, Immuneel Therapeutics, Rehan Khan, Managing Director, MSD India, and Priya Deshmukh, Head – Health Product, Services and Operations, ICICI Lombard discussed in detail how addressing the issues related to health insurance, prioritising accessibility and affordability and advancing research and innovation ecosystem can help the sector toward the road to billion-dollar drug.
“The definition of a billion-dollar drug is straightforward: one million people spending $1,000 a year, or 25,000 people spending $40,000 annually. Both of these patient pools exist in India. What is changing is that India, once a market defined entirely by generics, is now introducing advanced therapies, from immuno-oncology to CAR-T treatments for blood cancers, at dramatically reduced prices. In some cases, these are being offered at 5–8% of the costs charged in the United States,” said Mookim.
He added, “The gap, however, is not only about price. India’s fragmented healthcare system means business models must adapt to reach diverse patient segments. And for high-value therapies, reimbursement remains limited. The decade ahead is less about whether India will see a billion-dollar drug and more about how quickly its financing and delivery systems catch up with innovation.
Explaining the insurance and financial aspect, Deshmukh said, “Financing is where the promise of breakthrough therapies collides with ground reality. Insurance penetration remains just 3.7 per cent, even those who are covered often have policies capped at two or three lakh rupees. In the age of lifestyle diseases and oncology, this kind of insurance is clearly not enough.”
She further stressed, “The insurance paradigm is beginning to shift. Newer policies cover outpatient care, daycare and advanced treatments such as immunotherapy. Government schemes such as Ayushman Bharat have expanded awareness but remain limited in scope. Without deeper financial mechanisms, innovation risks outpacing affordability.”
Khan highlighted how the company’s cancer therapy, Keytruda, grew significantly after its pricing model was adapted to Indian realities. He said, “The scale in India is achieved not by charging high prices to a few, but by building mechanisms that reach many. Keytruda, initially priced well beyond the reach of most Indian patients, now costs less than 15 percent of its global price in some cases. As a result, its patient base expanded from 1,500 in 2017 to nearly 20,000 today, with Indian sales crossing $220 million.”
The experts concluded stating that the road to a billion-dollar drug is less about chasing a commercial figure and more about building a system capable of delivering billion-patient impact. When that system is in place, the billion-dollar product will follow and with it.