The jury is out on the size of this opportunity. Since 2005, any new drug sought to be patented globally after 1995 qualifies for an Indian patent. This limits what can be copied. Further, as MABs are large volume drugs (10 per cent of the world’s biotech medicines, but 75 per cent of the production capacity), they require large amounts of infrastrcuture investment. “Ramping up is expensive,” says Kaul. The big bucks lie in the West, where entry barriers are high. (See ‘Sticker Shock’, BW, 23 April 2007.)

Biocon has tried to avoid problems by tying up with the patent owner. “We want to be seen as partners in innovation,” says Subir Basak, general manager (oncotherapeutics). Indian regulators approved Biomab, the first drug from this partnership, before the West. This poses a challenge. Indian doctors prefer not to prescribe drugs that are not approved in the US or Europe, according to a Deutsche India Equities Research report. Basak says that oncologists wanted trial data on thousands of patients, like well-known global copycats, which Biocon did not have. This changed after experiencing the product, he claims.

At any time, there are 2.5 million cancer cases in India, but often drugs are too expensive. Purvish Parikh, chief (medical oncology), Mumbai’s Tata Memorial Hospital, says companies taking risk should mean more choice for patients. The ultimate proof, he says, is if “more patients are getting cured”.