Keytruda, a cancer drug made by Merck & Co, remains largely inaccessible in India due to high costs and relentless paperwork, enabling counterfeit drugs to enter the market, Express Investigation revealed. Each dose costs up to ₹3 lakh, and patients must pay ₹10 lakh upfront to qualify for free-dose programme. Patients earning over ₹25 lakh annually are excluded from programme.