Despite the modern drugs in chemotherapy and immunotherapy available in the country, oncologists are finding it difficult to treat advanced stages of breast cancer. Though it is possible to treat the cancer, the cure is less likely. This is because of tumour characteristics which include prognostic marker like ER, PR, Her2 neu, p53, to name a few. Other factors are patient characteristic like nutritional status and age of the patient. In addition, high cost of drugs, lack of insurance packages and government schemes make it a huge burden on patients who are having financial constraints.
There are also drug side-effects like low blood count and subsequent infections, hair fall and occasional nausea. Minor drug reactions are for a short duration but the challenge is to overcome this major disease. The advanced cases have lesser possibility for cure although the early cancer cases indicate extremely encouraging cure rates, stated Dr Niti Raizada Narang, consultant, medical oncologist, Health Care Global Enterprises (HCG).
The issue is that the chemotherapy and immunotherapy agents are extremely expensive and unaffordable for the most of the patients. This is where a health insurance can help the patients. There is also a need for government sponsored schemes to support the poor patients. Low cost but high quality care with patient-friendly delivery systems can help the growing number of breast cancer cases. Current incidence of breast cancer in India is estimated as one in every 22 women. Contrary to the West where early detection is possible because of the mandatory annual mammogram investigations, most women in India come in for diagnosis when the tumour is in advanced stage.
The rising number of breast cancer cases in India is attributed to the changing lifestyles. Only awareness on fatality of advanced stage cancer will goad women to go in for annual check ups to catch the tumour in the initial phase and commence the therapy modality at an early stage, added Dr Narang.
Indian oncology market size is $225 million, and is expected to reach $850 million by 2012, growing with a CAGR of nearly 30 per cent. Introduction of new treatments, increasing number of patients on chemotherapy and the increasing number of people gaining access to modern targeted therapies will contribute to industry sales of cancer drugs growing at a compound rate of 12 to 15 per cent. Chemotherapy drugs for breast cancer include Taxane group of drugs like Anthracyclines and anti-metabolites. Hormonal therapy covers tamoxifen and anastrazole immunotherapy drugs are trastuzumab and lapatinib.
Imported drugs are innovator molecules, but expensive. Indian drugs are mostly at par with the imported versions in terms of quality but prices are low because they are mostly generic versions, said Dr Narang.
Leading drug majors engaged in the production of the breast cancer drugs include BMS, AstraZeneca, Roche, Frasenius, Ranbaxy, Cipla and Sun Pharma among others. Last year, Biocon commenced marketing of Abraxane drug of the US-based Abraxis BioScience. This is priced at Rs. 17,200 a vial compared to its cost in US at Rs. 43,000.