Oncology Drugmakers See Gap Between Innovation and Real-World Care Gap

Indian oncology medicine manufacturers are witnessing a clear disconnect between rapid scientific innovation — including targeted therapies, biosimilars, next-generation sequencing (NGS), minimal residual disease assays, and immuno-oncology treatments — and their on-ground implementation in clinical settings, especially in resource-constrained environments.

This gap threatens to limit the benefits of precision medicine for the vast majority of cancer patients in India, where diagnostic access, referral pathways, and affordability remain uneven.

Key Challenges Identified by Industry

• Uneven Adoption of Advanced Therapies: While innovations such as biomarker-driven targeted therapies and immuno-oncology drugs are increasingly moving into earlier lines of treatment globally, their routine acceptance in India remains inconsistent. Factors include fragmented referral systems, variable diagnostic quality, and high out-of-pocket costs that force many patients toward suboptimal regimens.
• Diagnostic and Geographic Disparities: Sophisticated molecular testing required for personalised care is largely limited to major metropolitan centres. Patients in tier-2 and tier-3 cities, who form a significant portion of the cancer burden, often face delays or lack access to timely validated testing and biomarker analysis.
• Implementation Barriers: Even when innovations are available, challenges persist in patient selection, coordinated multidisciplinary care, and managing treatment in real-world settings. Overburdened public facilities frequently default to traditional protocols due to familiarity and lower monitoring demands.

Dr Shashank Srinivasan, Medical Affairs Director – Oncology Business Unit, AstraZeneca Pharma India, emphasised the shift brought by precision medicine: “Advances in precision medicine, cancer care in India has undergone a major shift. It is changing how the disease is understood and managed. This has opened doors to early intervention and personalised care. The challenge now is to ensure that these benefits are felt consistently in everyday practice.”

He further noted that bridging these barriers “requires a multidisciplinary, data-enabled, and patient-centred approach with disciplined execution across the care continuum.”

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Highlights:

• Disconnect between rapid oncology innovations and real-world delivery in India
• Emphasis on biomarker-led approaches and multidisciplinary care
• Role of tele-tumour boards for tier-2/3 access
• AstraZeneca’s support through diagnostics, education, and data partnerships
• Call for disciplined implementation to achieve health equity

Recommendations for Bridging the Gap

Industry experts advocate several practical measures:

• Expand Early Detection and Diagnostics: Improve diagnostic reach beyond metros through harmonised test menus aligned with guideline-mandated markers, strengthened external quality assurance, and co-location of biopsy, pathology, and molecular laboratories to reduce time-to-treatment.
• Leverage Multidisciplinary Tumour Boards (MTBs): Embed MTBs into standard workflows to enhance guideline adherence and reduce unwarranted variation in care. Tele-MTBs can extend specialist expertise from tertiary centres to district-level hospitals, promoting equitable decision-making for patients in smaller cities.
• Standardise Care Pathways and Data Utilisation: Focus on pathway standardisation, patient navigation, and capturing real-world data using standardised models with privacy-preserving analytics. This data should extend beyond clinical response to include quality of life, treatment burden, and long-term survivorship.
• Public-Private Collaboration: Manufacturers like AstraZeneca are supporting adoption through quality-assured diagnostics, clinician education programmes, and data partnerships with oncology networks to scale access and systematically measure outcomes.

Dr Srinivasan added that expanding early detection, improving diagnostic reach, and standardising evidence-based care pathways are “critical steps to address inequities.”

Broader Implications for Health Equity

The lessons from oncology extend to other high-burden non-communicable diseases such as cardiovascular, renal, metabolic, and respiratory conditions, where similar delays in diagnosis and fragmented pathways undermine patient outcomes.

In India, bridging science and practice is described as being “less about isolated breakthroughs and more about disciplined implementation.” Operationalising innovation demands focus on diagnostics access and quality, pathway standardisation, and effective navigation systems.

Without concerted action, the promise of transformative therapies risks remaining confined to select urban centres and clinical trials, rather than delivering measurable benefits to the wider population affected by cancer.

Manufacturers stress that when diagnostics, education, data partnerships, and coordinated care come together, scientific progress can translate into equitable and improved patient outcomes across the country.

Stakeholders expect intensified discussions in the coming months involving regulators, clinicians, medical associations, and patient groups to drive policy tweaks, capacity building, and faster integration of innovations into routine practice.