An investigation by The Indian Express has revealed a disturbing counterfeit cancer drug racket in India, where fake vials of Keytruda (pembrolizumab), an immunotherapy drug, are sold to patients at lower prices. Keytruda, which costs over ₹1.5 lakh (approximately $1,800 USD) per vial, is highly sought after due to its effectiveness against various cancers. The investigation uncovered a 12-member syndicate involved in the illegal trade, where hospital staff and middlemen were found diverting used vials, refilling them with other substances, and resealing them to appear genuine. This operation highlights significant gaps in regulatory oversight, as matching batch numbers indicated leaks from hospital supply chains. Merck & Co., the manufacturer of Keytruda, stated that healthcare facilities are responsible for disposing of used vials and that they lack visibility over how these vials are handled post-consumption. The findings raise critical questions about patient safety and the urgent need for improved regulations in India's healthcare system.