Affordable cancer care requires a state-run biological laboratory

Even two decades ago, Bangladesh's cancer treatment was heavily dependent on imported medicines. Today, however, the country's oncology landscape has progressed from basic chemotherapy to monoclonal antibodies, precision oncology, and even immunotherapy. SM Mahmudul Haque Pallab, Director, Sales and Marketing, Oncology Biotech and Palliative care of Beacon Pharmaceuticals Limited, spoke to The Business Standard's Staff Correspondent Tawsia Tajmim to discuss this transformation, the ongoing struggle to reduce treatment costs, and the challenges posed by the least developed countries (LDC) graduation.

What was the early phase of cancer treatment in Bangladesh?

At one time, it would not be an exaggeration to say that effective cancer treatment in Bangladesh was almost non-existent. The country was entirely import-dependent, with only two or three companies importing just four or five drugs—completely inadequate for a complex, long-term disease like cancer. Treatment was largely limited to palliative chemotherapy.

When did Beacon begin its journey in this field?

We started our journey in 2007 with basic chemotherapy. Initially, we began with seven or eight drugs, but based on direct guidance from oncologists, we gradually expanded the range according to clinical needs. Until 2015, our primary focus remained on basic chemotherapy.

Around 2015, monoclonal antibody therapy was introduced globally, bringing new hope to cancer treatment. We introduced antibody therapy in Bangladesh, and at present we have 18 antibody drugs.

From 2020, we will also began immunotherapy. So far, more than 2,000 doses have been administered to cancer patients, and we plan to gradually expand its scope further.

How many countries currently import Beacon's cancer medicines?

Through formal registration, our cancer medicines are exported to 26–27 countries. In addition, under WTO provisions that allow patients to procure medicines for personal use from any country, patients in nearly 130 countries are using cancer medicines manufactured in Bangladesh.

How important is precision oncology?

It is extremely important. Even with the same type of cancer, genetic mutations differ from patient to patient. Therefore, a single treatment approach does not work for everyone. This is where tyrosine kinase inhibitors (TKIs) and gene-based precision oncology drugs come in—medicines that we have introduced in Bangladesh.

What work are you doing on blood cancers?

Blood cancer is now one of the major areas of cancer research worldwide. We are working with immunotherapy for various blood cancers, including AML, CML, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. At the same time, we are in discussions with international experts to introduce the most advanced CAR-T cell therapy in Bangladesh.

Has local production reduced the price of cancer medicines?

Yes. In 2007, we introduced erlotinib for lung cancer and imatinib for blood cancer at prices nearly ten times lower than imported alternatives. Where prices abroad were in the thousands of taka, we were able to provide the medicines for just a few hundred taka.

Similarly, in the case of immunotherapy—where a single dose costs around Tk50–80 lakh in Bangkok or Singapore—we have been able to offer it in Bangladesh at around Tk2 lakh.

Then why is cancer treatment still expensive?

Because cancer treatment is inherently costly. To reduce costs further, active government support is essential.

What kind of government support do you mean?

The most crucial need is a state-run biological laboratory. Establishing a biological drug production lab is not feasible for any single company alone. If the government sets up a common biological lab where different companies can conduct research on different molecules, both cost efficiency and national capacity will increase.

China has successfully implemented such a model, where the government established immunotherapy facilities that multiple companies use for R&D before commercial production at their own plants.

How will LDC graduation affect cancer treatment?

It will pose a major challenge. Once LDC benefits are withdrawn, producing advanced medicines without paying royalties will become difficult. That is why we must build our own capabilities now—otherwise, the cost of cancer treatment will rise again.

What is the biggest obstacle to building that capability?

Skilled human resources. There is a significant shortage of scientists in Bangladesh with expertise in biological, gene-based, and cell therapies. Bringing back Bangladeshi scientists working abroad and training the next generation is the only viable solution.

Globally, academia and industry work hand in hand. Effective collaboration with our universities, medical colleges, and research institutions could bring transformative change to cancer treatment in Bangladesh.

What are your expectations from the new government after the election?

The establishment of a biological laboratory, capacity building, development of skilled human resources, and public–private partnerships. With these measures, Bangladesh can not only become self-reliant in cancer treatment but also play a meaningful role in the global market.

SM Mahmudul Haque Pallab, Director, Sales and Marketing, Beacon Pharmaceuticals Limited