What Is Targeted Therapy and Who Benefits From It?
The cost of targeted therapy in India for international patients is comparatively cheaper than in other countries. Targeted therapy is a kind of cancer treatment that aims at proteins and other elements in the human body that are responsible for the growth, multiplication and spread of tumours. Targeted therapies are considered to be highly effective as they focus on treating the cause of cancer spread throughout the human body.
A targeted therapy hails from the changes in the DNA and fights with the proteins that fuel the growth of cancer. These therapies are administered according to the type of cancers. Certain cancers perfectly respond to the targeted therapy treatments. However there are chances that some tumours and cancers do not respond to targeted therapies.
Your doctor may recommend a biopsy to find out if this therapy will suit your cancer treatment. A biopsy for biomarker testing helps in understanding the depth of the cancer spread in the body. This forms the basis for the further treatment plans.
Targeted therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide, and spread. It is the foundation of precision medicine. As researchers learn more about the DNA changes and proteins that drive cancer, they are better able to design treatments that target these proteins.
Key biomarkers: EGFR, ALK, BRCA, HER2, BCR-ABL
Biomarker testing is important for targeted therapies. Here is why it is important:
- One of the most important benefits of biomarker testing is that it has the capacity of evaluating a person's risk of getting hereditary diseases including cancer. This helps in conveniently staying away from the possible cancer risks of health hazards.
- Biomarker testing even helps in clinical trials to understand the best target therapy application. Biomarker testing forms an important segment of cost of targeted therapy in India for international patients.
- Biomarker testing helps in the right selection of targeted therapy. It helps in understanding the position of genes and molecular transformations. This helps in addressing the real cause behind the health issue.
- Biomarker testing even helps in understanding the response of your body to the target therapies used against cancer. It even analyses the entire treatment procedure and possible rebouncing of diseases.
Let us have a detailed look into the five important biomarkers :
1. EGFR (Epidermal Growth Factor Receptor)
The Epidermal Growth Factor Receptor is a protein that generally helps in the growth of cells. Common targeted therapies include Tyrosine Kinase Inhibitors (TKIs) such as erlotinib, osimertinib and gefitinib. It helps in Non-Small Cell Lung Cancer or NSCLC.
2. ALK (Anaplastic Lymphoma Kinase)
The Anaplastic Lymphoma Kinase is a gene that can work as an efficient oncogenic driver. This also helps in the cases of Non-Small Cell Lung Cancer or NSCLC. Some popular ALK inhibitors are alectinib, crizotinib and brigatinib.
3. BRCA (BReast Cancer gene 1 and 2)
Breast Cancer gene 1 and 2 is a tumor suppressor gene that repairs the damage done to the DNA. Common cancers that can be treated under this type of biomarkers are Breast, Ovarian, Pancreatic and Prostate cancers. cancers. Targeted therapies include inhibitors like enolaparib, niraparib and rucaparib.
4. HER2 (Human Epidermal growth factor Receptor 2)
HER2 or Human Epidermal growth factor Receptor 2 is a gene that promotes the growth of cells. Important cancer types treated with the help of these biomarkers are Gastric/Gastroesophageal and Breast cancers. Inhibitors include trastuzumab deruxtecan or Enhertu, pertuzumab and trastuzumab or Herceptin.
5. BCR-ABL
BCR-ABL is an abnormal chromosome or the Philadelphia chromosome created by a genetic swap, making a fusion protein that allows cells to grow in an uncontrollable manner. Acute Lymphoblastic Leukemia or ALL and Chronic Myeloid Leukemia or CML are some cancers treated by this biomarker. Targeted therapies include imatinib (Gleevec), nilotinib and dasatinib.
Genomic Testing & Liquid Biopsy in India
Liquid biopsies and Genomic testing is becoming popular in India. It has brought about a revolutionary transformation in the field of oncology and cancer care. The cost for an individual marker test ranges anywhere between $ 250 and $ 300. Liquid biopsies help in evaluating the circulating tumour DNA from the blood draw. Genomic testing in India for cancer and helps in determining the cancer presence as early as possible.
Popular Testing Centers & Providers Available in India
There are a number of personalized cancer care centres and big hospitals in India that offer genomic and biopsy testing. Here is a detailed list :
1.MedGenome
MedGenome is a famous genomics company that offers liquid biopsy panels like Minimal Residual Disease (MRD) testing and OncoFocus. The cost of targeted therapy in India for international patients is generally affordable at MedGenome.
2.Metropolis Healthcare
Metropolis Healthcare offers latest circulating tumor cell or CTC) tests and other important cancer testing services. Metropolis Healthcare is well known in India for some of the most reliable genomic testing.
3.Dr Lal PathLabs
Dr Lal PathLabs provides of DNA liquid biopsy tests like targeted tests for certain mutations like EGFR.
4.4baseCare
4baseCare gives the latest genomic profiling making an effective use of both liquid biopsy and tissue. This forms the basis of cancer treatment decisions.
Importance of Genomic testing and Liquid Biopsy
- Genomic testing and liquid biopsy helps a lot in forming a base for treatment selection against cancer.
- It even helps in identifying the future risks of hereditary diseases including colorectal and breast cancer.
- It helps in understanding the response to a targeted therapy against cancer and detects Minimal Residual Disease at the earliest.
'Get Your Tumour Profiled by India's Top Lab’
NGS testing cost in India vs. US ($500 vs. $3,000+)
Next-Generation Sequencing in India generally costs anywhere around $500. However the same comes at a minimum budget of $3,000 or more based on the size of panel. The lesser overhead costs including the affordable administrative and labour costs makes this price difference quite natural. Let us have a detailed look at the price difference related to Whole Genome Testing and Targeted Panels between India and the US.
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KIND OF TEST
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COST IN INDIA
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COST IN US
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CLINICAL EXOME SEQUENCING
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$ 300 to $ 1,200
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$ 3,000 to $ 5,000
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LIQUID BIOPSY
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$ 150 to $ 750
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$ 2,000 to $ 4,000
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WHOLE GENOME SEQUENCING
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$ 800 to $ 3,000
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$ 5,000 to $ 7,000
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Determinants of the Cost Difference
The "Cost-Saving" Perspective
The cost of handling medical requirements and hospital related overheads are quite lower in India than the United States. This is one of the most important factors that affects the cost of Next Generation Testing. The cost related to the maintenance of hospital and medical related infrastructure is quite lower in India. This makes the cost highly affordable.
Quality
Clinical laboratories in India like MedGenome follow all the global standards making the quality quite top class.
Insurance
There are a number of insurance plans and policies available in India. A sufficient insurance cover makes out of pocket expenses lesser than in the United States. This even contributes to the lesser cost of targeted therapy in India for international patients.
Turnaround time and actionability
Knowing about the turnaround time and actionability is an important thing that you need to study under this head. In oncology turnaround time is the period between biopsy acquisition and the visibility of biomarker results. Turnaround time is an important part of clinical actionability. This helps oncologists to understand the nature and type of targeted therapy that they can apply against specific cancers.
Time and accountability forms an important part of oncological care. While understanding about the cost of targeted therapy in India for international patients, it is also important to understand in detail about the turnaround time and accountability. Let us know in detail about the important information related to the turnaround time and accountability :
Allocation of Resources
There are a number of laboratories in India that offer on site testing and various important cancer testing facilities . This considerably reduces the turn around time. It makes testing and treatment decisions convenient and easier to reach at. This even helps in swift decision making reducing the turn around time and actionability.
Standard Next-Generation Sequencing (NGS)
Standard Next-Generation Sequencing (NGS) spans anywhere between 14 to 21 days. Tissue panels such as DNA/RNA and liquid biopsies usually need this time to get the accurate results. NGS is a prominent segment of turnaround and accountability.
Treatment Decisions
Treatment decisions can be swift and convenient due to the use of targeted therapies. The latest cancer testing technology and other important treatments and therapies are administered during the turnaround period to reduce further complications.
Immunohistochemistry (IHC) & FISH
Immunohistochemistry or IHC) & FISH offer quicker turnaround, normally offering results within 7 days. The percentage of solid tumors aiming at targetable biomarkers has quickly risen from 9% to about 30%.
Cost of Targeted Therapy Drugs in India
Targeted therapy is an important part of cancer treatment because target therapy in India for international patients is quite lesser than at international locations including Germany and USA. Targeted therapy drugs cost about $ 60 to $ 3000 per month depending upon the type of cancer and the brand of drugs used.
A number of reasons like lesser overhead cost, less cost of hospital maintenance and efficient labour costs makes the cost of targeted therapy considerably lesser in India than at western locations. Here is a detailed information regarding the cost of entire treatment cycle in India :
- The cost of Medication Per Cycle in India is between $600 and $3,600.
- The cost of Oncologist Consultation is between$20 and $60.
- The budget for Monitoring & Blood Tests is between $60 and $180.
- The budget for Diagnostic Scans in India is between $120 and $420.
Here is a detailed information regarding the monthly cost of drugs in India :
- The monthly Erlotinib cost in India is between $50 and $120 per month and it is administered for lung cancer issues.
- The budget for Gefitinib is between $25 and $70 per month and it is widely used for lung cancer.
- Trastuzumab that is used for breast cancer is between$240 and $420 per cycle.
- Osimertinib cost in India is between $1,400 and $1,900 per month and it is used against lung cancers.
- Regorafenib costs anywhere between $360 and $480 per month and it is applied in the cases of Colorectal Cancer and GIST.
Here is how patients can cut on cost for targeted therapies :
Buying Health Insurance
There are a number of health insurance policies available in India covering financial burden arising out of medical emergencies including cancer. The cost of targeted therapy in India for international patients reduces a lot due to sufficient medical insurance.
Patient Assistance Programs or PAPs
Numerous multinational pharmaceutical companies offer discounts, financial help, or co-pay facilities making costs lesser.
Janaushadhi Kendras
Indian government sponsored Janaushadhi Kendras offer generic drugs at affordable cost. This makes the cost of targeted therapy much lesser for international patients.
Generic vs. branded versions - quality assurance
Generic and branded versions of targeted therapies have the same active pharmaceutical ingredient or API. The main differences are on the basis of cost, government control and excipients. It must match the standards for strength, power, dosage, and clinical efficacy. Let us understand the difference in detail :
Standard Generic
The Standard Generic is a non-patented version that is sold in the market by numerous producers. These products go through strict testing. However these are cheaper at all times. The cost of targeted therapy in India for international patients reduces with their use.
Branded Generic
Branded Generic is a generic version marketed under a business trade name by a generic manufacturer. The prices are comparatively more than generic products.
Both the branded and Generic versions offer the same level of efficacy. However the cost certainly differs according to the kind. The Government of India has a stricter control over Generic brands.
Monthly drug cost comparisons: Imatinib, Erlotinib, Osimertinib
Knowing about the monthly drug cost comparisons between the targeted cancer therapies is important. This clears the budgetary requirements of your cancer treatment therapies. Here is a detailed comparison of monthly costs for Osimertinib. Imatinib and Erlotinib.
Imatinib Generic
Imatinib Generic is highly affordable due to convenient and large-scale availability. The cost of this drug in the US is between $100 to $150 per month after discount. The same drugs are available at a cost between INR 1,500 and INR 3,000 per month. Certain brands cost even higher in the US.
Erlotinib Generic
The cost for Erlotinib Generic per month is normally between $850 and $1,500 varying on the basis of the brands.
The same cost in India is between INR 2,000 and INR 10,000 per month. Certain brands like Tarceva can cost $10,000 per month in the US. The cost of Erlotinib Generic forms an important part of the cost of targeted therapy in India for international patients.
Osimertinib Brand (Tagrisso)
Osimertinib Brand ( Tagrisso ) is a highly expensive drug for targeted therapies. The cost of this drug in the US is between $16,000 to $20,000+ per month. The same cost is between INR 1,00,000 and INR 4,00,000 per month on the basis of other variables. The cost of targeted therapy in India for international patients includes this cost too.
Factors Determining the Cost of Drugs
Patient Assistance Programs or PAP : Large and famous pharmaceutical companies provide medical assistance programs for uninsured patients.
Payer Considerations : The paying capabilities of the cancer patient is also important in determining the cost of drugs.
Country or Location : Nationalized and government sponsored healthcare plans greatly reduce the cost of drugs used in the treatment of cancer.
Frequently Asked Questions
1Q: Is genomic testing available in India for cancer?
Ans: Genomic testing is an easily and conveniently available cancer testing in India. This is used for cancer screening, evaluating hereditary danger, and helping targeted therapies. Popular healthcare networks offering such testing include Apollo Hospitals, MedGenome, ACTREC and Mapmygenome.
2Q: How much does targeted therapy cost in India?
Ans: Targeted therapy in India normally costs between INR 80,000 to INR 3,00,000+ per month or per treatment cycle basis. The cost mainly depends upon the cancer stage, specialization, medication, and type of cancer too. The cost of a targeted therapy can vary according to the location of the cancer treatment centre too.
