The cancer drug Keytruda, produced by Merck, has revolutionized treatment for 22 types of cancers but remains prohibitively expensive for many patients worldwide, particularly in India, where it can cost up to ₹1.5 lakh per dose. Reports indicate that high pricing and a growing demand for the drug have led to a surge in counterfeit versions, putting patients at risk. Investigations have uncovered cases of fake Keytruda being sold in Indian hospitals, prompting concerns about safety and the integrity of healthcare facilities. As Merck maintains its high prices through patents and market control, questions arise about the global divide in access to this lifesaving treatment, with some countries like Belgium facing potential costs as high as €2.6 billion for the drug. The situation calls for a closer look at regulatory frameworks to combat the counterfeit drug market and improve affordability for cancer patients.