Immunotherapy medicines · Nivolumab cost
Most people reach this page because nivolumab is written on a prescription and the first quote was frightening. Below are the per-vial figures published as of August 2026, with the source and date against each one — and what a hospital bill adds on top of them.
Free consultation · itemised in writing · no commitment to start treatment. Eligibility comes before cost, and the estimate is built against your prescription and your reports — not quoted against a medicine over the phone.
Prescription-only medicine. Nivolumab is a prescription-only intravenous medicine, given only under a medical oncologist’s supervision in a monitored day-care setting, and only for the cancer types and clinical situations it is approved for in India. Nothing on this page is a recommendation to use this medicine, or to choose one brand of it over another — see “Who nivolumab is not for” below.
Published figures
Published January 2026 amounts. The originator is quoted as one range across dosage forms rather than per strength, so a like-for-like per-vial comparison is not available for the 40 mg.
| Item | Opdyta (originator) | Tishtha (biosimilar) |
|---|---|---|
| Marketed by | Bristol Myers Squibb | Zydus Lifesciences |
| Type | Reference (originator) product | Biosimilar, CDSCO-assessed |
| Indicative price, 40 mg vial* | Quoted as one range, ₹36,000 – 90,000+, across all dosage forms | ₹13,950 |
| Indicative price, 100 mg vial* | As above — not published per strength | ₹28,950 |
| Relative position | Reference price | Approximately one quarter of the reference price |
| Source and date | Business Standard, 22 January 2026 | Zydus regulatory filing, 22 January 2026 |
*Indicative only, as of August 2026, from published reporting and a company regulatory filing — not a CION price list, and not a quote. Confirm the current figure with your hospital’s pharmacy before budgeting.
A biosimilar is not a generic copy — it is the same molecule, assessed by CDSCO before it reached the market (is a nivolumab biosimilar as good as Opdyta?). Which product you get is a decision for your oncologist and the hospital pharmacy, not one to make on price.
A published vial price is not what a hospital bills. Your dose decides the vial count, and the day care and monitoring sit on top of it.
Free consultation · itemised in writing · no commitment to start treatment
Work it out
The dose your oncologist writes decides how many vials the pharmacy dispenses for a single sitting, which is why two people on the same medicine can have very different drug costs per visit. Pick a strength and a vial count.
Published biosimilar drug cost, one sitting
Not sure how many vials your dose needs? That is a question for the treating team, or for our helpline.
Drug only, at the published Tishtha filing price — it excludes day care, nursing, pre-medication, pre-cycle bloods, review and imaging, and it is not a CION quote. Your oncologist decides the dose; nothing here does.
Vial, cycle, course
Because a vial price is not a cycle price, and a cycle price is not a course price. Nivolumab is given by intravenous infusion every two or four weeks, continued for as long as it is working and tolerated — so the number that matters is the one that repeats.
The rest of the bill sits around the drug:
The infusion chair, nursing time and observation period — a same-day charge at CION centres, not an admission.
Lines, fluids and any medicines given before the infusion starts.
Thyroid, liver, kidney and blood-count checks before each cycle, because immune side effects show on bloodwork first.
The oncologist assessment attached to each cycle.
Periodic scans to see whether treatment is working, coordinated at partner centres and billed separately.
Ask any hospital for an itemised quote that separates drug cost, day-care charge and monitoring tests. A single bundled per-cycle number cannot be compared fairly against a published vial price, or against another hospital’s bundled number.
Ask for it itemised, and hold it against ours. We separate drug, day care and monitoring on every estimate we write.
Free consultation · itemised in writing · no commitment to start treatment
Cover
Sometimes, partly, and never assume it. Coverage turns on the scheme, on whether the hospital is empanelled and on the protocol prescribed — not the drug’s name. A scheme ceiling such as Aarogyasri is fixed by the package and rarely stretches to a full course of a high-cost injectable, and private policies differ on injectable-oncology sub-limits. A biosimilar’s lower price brings a course closer to a ceiling than the originator did; whether it falls inside one is a question for the hospital’s insurance desk, in writing, before treatment starts.
Scheme ceilings and insurance sub-limits change. Any figure quoted today should be reconfirmed at the point of admission.
Whether a scheme ceiling or an injectable sub-limit reaches your course is a question for a person with your policy in front of them.
Free consultation · itemised in writing · no commitment to start treatment
Eligibility comes first
A lower price does not widen who nivolumab is suitable for. It is approved for particular cancer types in particular clinical situations, and for a large share of patients it is not an option at any price — worth saying plainly on a cost page, because cost pages are where hope tends to outrun eligibility.
It is generally not used, or used only with specialist caution, in people who:
None of these are rules you can apply to yourself from a web page. Only the treating oncology team, with your scans, pathology and biomarker results in front of them, can say whether nivolumab applies to your case.
Talk to an oncologist
Eligibility comes before cost. A CION medical oncologist can tell you whether a checkpoint inhibitor is even an option for your cancer type, stage and biomarker results — which is the question underneath the price.
One helpline serves every CION centre, open 24/7. We do not quote a rate against any named medicine over the phone.
Your own numbers
Everything above is a published figure from someone else’s reporting. A CION consultation gives you the other thing — your own plan, priced line by line: the drug at the strength and vial count your prescription actually needs, the day care, nursing, pre-cycle bloods and review around it, and which cover your case qualifies for. In writing, before the first cycle.
The consultation is free and carries no commitment to start treatment. We still quote no rate against a named medicine over the phone — the estimate is built against your prescription and your reports.
Supply-chain safety
Treat an unusually low price from an unofficial source as a warning sign, not a saving. Counterfeit checkpoint inhibitors have been reported in India around patent expiry, and a family under cost pressure is who such an offer is aimed at. Nivolumab must also stay refrigerated from manufacture to infusion, and a vial that warmed looks normal.
Source it through the treating hospital’s licensed pharmacy, or one your hospital names, so batch number, expiry and cold-chain handling are documented.
Keep the invoice and the batch details, in case a side effect is investigated or a recall is issued.
Be wary of vials offered through social media groups, resellers or informal patient networks — and if a price sits far below the published figures above, ask where the vial came from and to see the cold-chain record before anything is bought.
Seal intact and unpeeled, batch number matching the invoice, expiry legible and not overprinted. A resealed or relabelled carton is the commonest physical sign of a counterfeit, and all of it is visible before anything is opened.
This is a patient-safety point, not a commercial one: a legitimate biosimilar now exists at roughly a quarter of the reference price, which removes most of the reason to take a risk outside a regulated channel. More at counterfeit immunotherapy drugs in India.
Your questions
Three things changed in quick succession. On 12 January 2026 a Delhi High Court division bench allowed Zydus Lifesciences to sell a nivolumab biosimilar before the originator patent lapsed, on public-interest grounds. On 22 January 2026 Zydus launched that biosimilar as Tishtha, cleared by CDSCO, at approximately one quarter of the reference price. The Indian patent on nivolumab then expired on 2 May 2026, removing the legal barrier to further biosimilar entry. Nivolumab is currently the only checkpoint inhibitor in India whose economics have shifted this way.
As of August 2026: Tishtha at ₹13,950 for a 40 mg vial and ₹28,950 for a 100 mg vial, from the Zydus regulatory filing of 22 January 2026; and Opdyta at an indicative ₹36,000 to over ₹90,000 per vial across dosage forms, from Business Standard reporting of the same date. These are published figures, not quotes, and a hospital bill adds day-care and monitoring charges on top of the drug.
A biosimilar is not a generic copy. It is a biological medicine shown to be highly similar to an already approved reference product, with no clinically meaningful difference in quality, safety or the way it works. Tishtha was assessed by CDSCO, India’s drug regulator, against those biosimilar requirements before it was allowed on the market. It is the same molecule, nivolumab, made by a different manufacturer. Whether the originator or a biosimilar is used in your case is a decision for your treating oncologist, not a decision to be made on price alone.
A vial price is not a cycle price. One dose can need more than one vial, and the bill then adds day care, nursing, pre-medication, pre-cycle blood tests and the review consultation. Hospitals also buy at different negotiated rates. Ask for an itemised quote that separates drug cost from day-care and monitoring, so it can be compared against a published vial price.
No. Price does not change eligibility. Nivolumab is approved for specific cancer types and clinical situations, and for many patients it is not an appropriate option whatever it costs. People with active autoimmune disease, people on high-dose immunosuppression and solid-organ transplant recipients often cannot receive it safely. Your cancer type, stage, biomarker results and general fitness decide whether it applies at all. A lower price widens access for people who were already candidates; it does not make anyone a candidate.
Still working out what this would cost you? One call, and every route you qualify for is applied to your own plan before you see a number.
Free consultation · itemised in writing · no commitment to start treatment
Price figures are indicative, published and dated; they are not CION rates. Treatment decisions belong with your treating oncologist, with your reports in front of them.
Medical disclaimer: This page is for general information and awareness and does not replace a consultation with a qualified oncologist. Nothing here is a recommendation to use nivolumab, to choose one brand of it over another, or to change a treatment plan. Prices are indicative published figures from named third-party sources on the dates stated, not a CION price list and not a quote. Speak to your treating team about anything that worries you.
