The rise of counterfeit versions of Keytruda, an immunotherapy drug for cancer developed by Merck & Co., has raised serious concerns regarding patient safety and treatment costs in India. Oncologists, including Dr. Abhishek Shankar from the All India Institute of Medical Sciences in Delhi, highlight that while Keytruda has shown significant efficacy, particularly in patients with high PD-L1 expression, its cost of ₹1.5 lakh per month remains unaffordable for many, leading them to seek cheaper alternatives from unregulated markets. Investigations reveal that counterfeit Keytruda vials are infiltrating the market, often through informal supply chains, which can include reused vials from legitimate treatments. This malpractice not only jeopardizes patient safety but can lead to ineffective treatments and even premature death. Dr. Aditya Sarin from Sir Ganga Ram Hospital echoes these concerns, emphasizing that counterfeit drugs represent a grave risk to cancer care. He advocates for sourcing medications through authorized channels to ensure authenticity. As India's cancer burden grows, the counterfeit Keytruda crisis highlights the urgent need for improved regulations and access to verified therapies to safeguard patient health.