Quick answer: In October 2026, a 100 mg vial of Keytruda (pembrolizumab) carries a printed MRP of roughly ₹1.85–2.17 lakh in India, and pharmacies often sell it for less. The usual adult dose is 200 mg every three weeks, which needs two vials. That puts the drug alone at roughly ₹3.4–4.3 lakh per cycle, before hospital, test and scan charges.

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What is Keytruda?

Keytruda is the brand name of pembrolizumab, made by MSD. It belongs to a group of medicines called immune checkpoint inhibitors.

Cancer cells often switch off the immune system by using a “brake” called PD-1 on T cells. Pembrolizumab blocks that brake so T cells can recognise and attack the cancer again.

It is used for many cancers, including certain lung, melanoma, head and neck, kidney, bladder, cervical, stomach, oesophageal and triple-negative breast cancers. Whether it suits a particular patient depends on the cancer type, its stage, and biomarker tests such as PD-L1, MSI or TMB.

Keytruda price in India (October 2026)

There is no single official price list that every hospital follows. The figures below come from published pharmacy listings and cost guides, checked in October 2026. Treat them as indicative and confirm with your hospital pharmacy.

Item	Indicative price	Notes
Keytruda 100 mg/4 ml vial (MRP)	₹1.85–2.17 lakh	Printed MRP varies by batch and seller
Keytruda 100 mg vial (pharmacy selling price)	₹1.68–1.90 lakh	Online and retail listings are often below MRP
One 200 mg dose (2 vials)	₹3.4–4.3 lakh	Drug only, every 3 weeks
One 400 mg dose (4 vials)	₹6.8–8.7 lakh	Drug only, every 6 weeks

Hospitals may charge more than pharmacy prices because of handling, cold-chain storage and day-care fees. Always ask for the per-vial price in writing.

Cost per cycle and per year

The internationally approved adult schedules are 200 mg every 3 weeks or 400 mg every 6 weeks. The 400 mg schedule was approved in 2020 on the basis of modelling, which showed drug levels similar to the 3-weekly dose. Over a given period both schedules use the same total amount of medicine, so the 6-weekly option saves hospital visits, not drug cost.

• Per 3-week cycle: about ₹3.4–4.3 lakh for the drug.
• Per year (about 17 cycles): about ₹58–73 lakh for the drug alone.
• How long treatment lasts: in many of the trials that led to approval, patients with advanced cancer were treated for up to 35 cycles, about two years. For some cancers, such as treatment after surgery for melanoma or kidney cancer, the course is shorter, often about one year.

Your oncologist will set the plan, and it may change if the cancer responds, progresses, or side effects develop.

Other costs to budget for

The vial is the biggest cost, but not the only one. A realistic budget includes:

• Biomarker tests before starting: for example, a PD-L1 test on the tumour sample, and sometimes MSI/MMR or TMB testing.
• Day-care infusion charges: the drug is given as a 30-minute drip.
• Blood tests before each cycle: liver, kidney and thyroid function, and blood counts.
• Scans every 2–3 months: CT or PET-CT to check the response.
• Treatment of side effects: immune-related side effects such as thyroid problems, colitis or pneumonitis may need steroids, hormone tablets or a hospital stay.
• Travel and stay if you are treated away from home.

Why is Keytruda so expensive?

Pembrolizumab is a monoclonal antibody: a large protein made in living cells under strictly controlled conditions. Development costs were high, the medicine is still under patent in India, and there is no approved biosimilar to compete on price yet.

Will a cheaper pembrolizumab biosimilar come to India?

Reports indicate that MSD’s Indian patent on pembrolizumab runs until 2028, so a biosimilar is unlikely to be sold widely before then.

The closest example is nivolumab, another PD-1 inhibitor. After the Delhi High Court allowed it to be sold, Zydus launched the world’s first nivolumab biosimilar, Tishtha, in India in January 2026. It was priced at ₹28,950 for a 100 mg vial and ₹13,950 for a 40 mg vial, about a quarter of the reference brand’s price. A similar fall in pembrolizumab prices is possible once its patent ends.

Are there lower-cost alternatives?

Several other checkpoint inhibitors are sold in India, including nivolumab (originator and biosimilars), atezolizumab, durvalumab, toripalimab and tislelizumab. These drugs are not interchangeable, though. Each is approved for specific cancers and lines of treatment, and the evidence differs between them. Ask your oncologist:

• Is there an equally effective, approved option for my cancer that costs less?
• Would a biosimilar be appropriate in my case?
• Is weight-based dosing reasonable for me? Pembrolizumab was first approved at 2 mg/kg every 3 weeks, and for a lighter patient that can mean fewer milligrams per dose.

Indian researchers have also studied low-dose immunotherapy approaches, such as low-dose nivolumab in head and neck cancer at Tata Memorial Centre. Never change a dose on your own. Any dosing decision must come from your treating oncologist.

Ways to manage the cost

1. Check your health insurance policy. Since IRDAI’s 2019 guidelines, many Indian policies cover “modern treatments”, including immunotherapy given as a monoclonal antibody injection, but often with a sub-limit. Ask your insurer in writing what is covered and up to what amount.
2. Government schemes. Ayushman Bharat PM-JAY covers up to ₹5 lakh per family per year at empanelled hospitals. Immunotherapy is not a routine package in every hospital, so ask the empanelled hospital’s PM-JAY desk directly. CGHS and state employee schemes have their own rules.
3. Manufacturer access programmes. Ask the hospital pharmacy or the company whether any patient-assistance or shared-cost programme is currently available. Terms change and eligibility varies.
4. Clinical trials. Trials registered on the Clinical Trials Registry – India (CTRI) sometimes provide the study drug free of cost.
5. Charitable support and crowdfunding. See our guide to financial assistance for cancer patients.

Where does Denvax fit in?

Denvax provides personalised dendritic cell immunotherapy, made from the patient’s own blood cells. It is planned as an add-on to standard cancer treatment such as surgery, chemotherapy, radiation or checkpoint inhibitors, not as a replacement for them.

If you are weighing up immunotherapy options and costs, our doctors can review your reports and explain where each option may fit in your treatment plan. Book a consultation or call 1800 123 1132 (toll-free).

Frequently asked questions

References

1. CION Cancer Clinics. Pembrolizumab (Keytruda) price in India: 2026 costs. cioncancerclinics.com (accessed Oct 2026).
2. Medkart. Keytruda 100 mg/4 ml injection, price listing. medkart.in (accessed Oct 2026).
3. US FDA approval of pembrolizumab 400 mg every 6 weeks dosing, April 2020. OncLive.
4. Pharmaceutical Benefits Advisory Committee (Australia). Pembrolizumab public summary document, July 2022 (treatment limited to 35 cycles/24 months). pbs.gov.au.
5. Zydus launches nivolumab biosimilar Tishtha in India at one-fourth the cost, January 2026. Kotak Neo News.
6. Pearce IP. BMS seeks leave to appeal Zydus’ win in biosimilar nivolumab dispute, January 2026. pearceip.law.
7. CION Cancer Clinics. When will a pembrolizumab (Keytruda) biosimilar reach India? cioncancerclinics.com.
8. National Health Authority. Ayushman Bharat PM-JAY. pmjay.gov.in.
9. Clinical Trials Registry – India. ctri.nic.in.

Medically reviewed by Dr Sharmin Yaqin, MBBS MD · Last updated: October 2026

This article is for general information only and is not medical advice. Drug prices are indicative, based on published sources as of October 2026, and may change. Treatment decisions, including the choice and dose of any medicine, must be made with your treating oncologist.