A Brief History of Scale and an Unasked Question
In 1989, oncology in India was not a business unit. It was a scientific outpost. In that era, practitioners measured success by the depth of a clinical conversation, not the breadth of a commercial dashboard. Clinical trials were rare. Drug innovation was a distant hum, not a strategic drumbeat. The patient who walked into a cancer ward often walked out with little but a prescription for a molecule that had remained unchanged for a generation.
Four decades later, the Indian oncology ecosystem is unrecognisable. It has grown into a multi-billion-dollar strategic chess match, with global pharmaceutical majors vying for position, homegrown biopharma firms scaling biosimilar pipelines, and a domestic clinical trial infrastructure that rivals many Western centres. As Subroto Banerjee observed, however, the transformation has come with a lingering question: Have we lost the plot?
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