In recent years, CAR T-cell therapy has emerged as one of the most promising advances in cancer treatment, offering new hope to patients with aggressive and resistant forms of blood cancer. By harnessing the power of a patient’s immune system, this personalised therapy has demonstrated remarkable clinical outcomes. However, despite its transformative potential, the high cost of CAR T-cell therapy remains a major barrier to access, especially in countries like India, where affordability is key to equitable healthcare.

As India looks to scale this innovation for broader impact, the focus must shift toward reducing costs without compromising on quality. Local manufacturing of key components is essential to break dependency on global supply chains, reduce import costs, and ensure timely, consistent access to critical materials. Aligning with this vision, the Indian government is pursuing several initiatives to boost local production of therapies. These include the Production Linked Incentive (PLI) Scheme for medicines and the National Policy for Rare Diseases 2021. These steps are essential not only to make advanced therapies like CAR T-cell more accessible to Indian patients but also to position India as a global hub for affordable, cutting-edge cancer care.

Cost Challenge in Advanced Cell and Gene Therapies

CAR T-cell therapy is currently among the most expensive cancer treatments globally. Key contributors to this include imported raw materials, expensive vector production, technology licensing fees, and complex logistics. In India, while the cost is already approximately 80–90% lower compared to developed countries, it remains a significant burden for most patients. Bridging this gap requires systemic changes that address the root cost drivers.

Localisation of Key Components

A significant portion of the current cost comes from dependence on imported raw materials such as viral vectors, reagents, and cell culture media. Localising the production of these components can dramatically reduce costs and insulate the supply chain from global disruptions. Embracing the Make in India vision, the domestic biotechnology sector has a unique opportunity to innovate and manufacture critical inputs right here, bringing down costs while ensuring consistency and quality. India has strong capabilities in biosciences and a growing ecosystem of researchers, innovators, and manufacturing partners. By fostering academic-industry partnerships and incentivising indigenous production, we can accelerate the development of locally sourced, GMP-grade materials. This not only drives affordability but also creates IP, builds export potential, and establishes India as a self-reliant hub for next-generation therapies.

Scaling Up Manufacturing

Affordability improves significantly when production scales up. As patient volumes grow, economies of scale can help reduce the per-patient cost of therapy. India needs to invest in modular, scalable manufacturing facilities designed for flexibility and speed. Automation and digital process control can further optimise costs. Supportive policies, including grants and infrastructure subsidies, can encourage companies to build and expand GMP-certified facilities, improving nationwide access and consistency in quality.

Skilling Programs for Next-Gen Therapies

Specialised training programs for medical professionals, technicians, researchers, and regulatory experts will ensure that the ecosystem is equipped to deliver these therapies at scale. Academic institutions, biotech companies, and government bodies must work together to create skilling modules that address the unique complexities of cell and gene therapy. Investing in people is as critical as investing in infrastructure.

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Role of Public-Private Partnerships and Regulatory Support

Transforming India into a cell and gene therapy (CGT) leader will require collaboration. Public-private partnerships can catalyse progress by combining the strengths of government, academia, and industry. Fast-track regulatory pathways, shared infrastructure, and policy incentives can reduce time-to-market for affordable therapies. India’s past success in vaccines and generics shows that cost-effective innovation is possible at scale. Similar lessons must now be applied to complex therapies like CAR T-cell.

India as a Global CGT Hub

India has the potential to not only meet domestic demand but also serve the broader global south. Affordable, high-quality CAR T-cell therapy can attract international patients, strengthening India’s medical tourism sector. With the right mix of affordability, innovation, and regulatory agility, India can export these therapies to other low- and middle-income countries, playing a pivotal role in the global fight against cancer.

Localisation and scaling are not just about reducing costs—they are essential to saving lives. With investment in local production, talent, and partnerships, India can lead in making world-class cancer care accessible to all.

Views shared by: Amit Mookim, CEO, Immuneel Therapeutics

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