Cancer therapy shifting from patient-fitting treatment to treatment-fitting patient model: Novartis India MD

Amitabh Dube is the country president and managing director at Novartis India. Prior to his stint with Novartis in various positions, Dube had worked with Roche, another Swiss pharmaceutical company, as business director of the oncology business unit. In this chat with Moneycontrol, he talks about the present and future state of cancer therapy, ahead of World Cancer Day on February 4. Edited excerpts:

Are there any drugs or therapeutics that Novartis is looking to launch in India in the coming months?

At Novartis, we are committed to reimagining cancer care and are continuously pushing the limits of science to develop innovative therapies that can provide a potential cure to cancer.

We are developing new therapies for a range of common and rare cancers, investing in diverse technology platforms, and experimenting with combination approaches. These therapies have the potential to be new foundations for cancer care in areas with great unmet needs. For the past two decades, we have led the growth of targeted therapies in cancer and revolutionised oncology research.

They include the first targeted therapy for Chronic Myeloid Leukemia (CML), Tyrosine Kinase Inhibitor (TKI),2, endocrine therapy for HR+ Her2-ve breast cancer and targeted therapy for non-small-cell lung cancer.

The goal of therapy is shifting from making the ‘patient fit the treatment’ model to making the ‘treatment fit the patient’ one.

What do you think about the oncology market in India? What are the challenges and opportunities in the sector?

The oncology market in India is estimated to grow by $734.18 million in 2025, growing at a CAGR of 13.02 percent. Even though there has been substantial advancement in cancer treatment, a person seeking cancer care encounters obstacles at every stage of his journey -- from diagnosis to treatment and post-treatment support.

The rising burden of cancer-related morbidity and mortality is further exacerbated by late-stage manifestation and limited access to optimum diagnosis and treatment. To lessen cancer disparities, immediate steps must be taken to close the gap and ensure equitable access to advanced cancer treatments.

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Targeted therapies and ongoing advancements in cancer treatment have improved the outcomes and quality of life of patients. All this is because today, as the healthcare industry understands cancer better, we can work around it holistically.

We are witnessing the possibility of more accurate diagnosis, individualised treatment, and greater insights into the impact of treatment and care for patients, thanks to the increasingly broad array of data at our disposal. However, these innovations will only be successful if they can reach a much larger segment of the population through joint efforts. Meeting this objective is challenging. However, we can win by working cohesively.

When it comes to cancer therapeutics, affordability is a major concern from the patients’ point of view. How do you think the pharma sector can make access to drugs easier for patients?

With the current healthcare demand, there are significant gaps in funding to pay for the treatment. The financing gap for cancer is substantial and no single entity can tackle the issue alone. Hence, strategic cross-industry partnerships, like between pharmaceutical companies and insurers, can help in developing cancer-care packages and bring quality care to those who typically lack access.

The industry undertakes several initiatives, such as patient access or support programmes, which help in addressing affordability challenges, especially for self-paying patients through treatment-cost reduction, increasing the ability to pay, and working with healthcare system partners.

Innovative payment models for patients, such as micro-financing schemes, can reduce the monthly outlay for patients who aspire for quality treatment but are not able to pay upfront. Through these financing schemes, such patients can help onboard therapy and have the flexibility to pay overtime.

What do you think about government intervention in oncology therapeutics in India? Are they enough? What more do you think can be done?

Access to cancer care has long been a priority on the public health agenda, and Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana has been a landmark policy of the government towards achieving universal healthcare.

While several steps are encouraging and have provided optimistic results, some more measures could be taken to reduce the gaps. For instance, exploring and furthering collaborations between different stakeholders – the public and the private sector, civil society, and global health agencies -- become important.

It is worthwhile to note that cancer care requires broad areas of expertise, and no single entity will be able to create an impact. The AIDS epidemic is a good example of successful ecosystem partnerships. The disease was specifically prevalent in low-middle income countries where the health infrastructure was weak and critical medicines were unavailable. The impetus also needs to be on furthering innovation in cancer care.

As further research can help find better ways to prevent, diagnose, and treat cancer, we believe research-linked incentive (RLI) schemes, shaped along the lines of the PLI programme, to cover R&D costs for biotech products is required to accelerate the accessibility, affordability, and availability of life-saving cancer drugs.

When it comes to cancer drugs, what can be expected in the future in terms of research and innovation?

Cancer is often referred to as the ‘pathology of the century’. According to National Cancer Institute data, there has been a continuous and almost stable increase in the incidence rates of all types of cancers.

With newer therapies, unique mechanisms, target-based precision, immune mediated therapies and adoptive cellular techniques, the mortality rate in cancer is steadily declining.

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Precision medicine is helping move cancer treatment from a one-size-fits-all model to an approach where doctors can choose treatments that are most likely to successfully treat a person’s cancer, based on the detailed genetic information of that person’s specific cancer.

With advances leading to faster and less expensive gene sequencing, precision medicine is starting to be used more often to treat patients, most notably in the treatment of lung cancer. This quest for precision is also extending to other fields like breast cancer, leukemias, pancreatic and brain cancers, to name a few.

The topic of interest in immunotherapy, going ahead, will be combining agents that target independent pathways to get better tumour suppression, development of more effective cancer vaccines, and more advanced techniques to be able to measure “molecular residual disease” or to detect and measure microscopic residual disease in patients who have undergone definitive treatment, which will be game changers in oncology.

Scientists are optimistic that advancements in oncology research with precision medication, targeted immunotherapies, and smart lifestyle choices will help prevent and treat cancer in a considerably greater percentage of instances.