Just days before Christmas 2025, leaders of nine pharmaceutical companies clustered in the Roosevelt Room of the White House, where Teddy Roosevelt\u2019s 1906 Nobel Peace Prize once hung. Photographers flocked for pictures as the executives, three women and six men, stood awkwardly, tapping their feet and drumming their fingers while waiting for President Donald Trump. The pharma chiefs had all struck deals to slash prices on some of their flagship drugs.<\/p>\n
Nearly 15 minutes passed before Trump entered the room, trailed by Health and Human Services Secretary Robert F. Kennedy Jr. and several senior officials. The president glanced at the executives.<\/p>\n
\u201cWow, what a group of people,\u201d Trump said. \u201cThey make a lot of money.\u201d<\/p>\n
Collectively, their annual compensation topped $100 million. But only one \u2014 the bespectacled corporate lawyer with a goatee \u2014 was at the helm of a $65 billion drug juggernaut with a lifesaving medicine that was unaffordable for much of the world: Robert M. Davis, CEO and chairman of Merck & Co., maker of the anti-cancer blockbuster pembrolizumab. Brand name: Keytruda.<\/p>\n
Trump promised drug prices would plummet \u201cfast and furious\u201d because of the new deals. Before the ceremony ended each executive stepped to the lectern to say a few words. When it was Davis\u2019 turn, he declared \u201c100%\u201d support for the president\u2019s actions.<\/p>\n
![\"Four](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Davis-Trump-White-House-GettyImages-2252069548-1138x640.jpg\")
\n Merck CEO Robert M. Davis, wearing a blue suit, stands between the heads of other major pharmaceutical companies as President Donald Trump announces a deal to lower drug prices at the White House in December 2025. Image: Brendan Smialowski \/ AFP via Getty Images <\/p>\n
\u201cI reflect on your goal of driving affordability and access to Americans but equally of getting prices up outside the U.S.,\u201d Davis said.<\/p>\n
He vowed Merck would drop prices on a diabetes drug and a cardiovascular pill, but he didn\u2019t say anything about cutting the cost of Keytruda, which accounted for $31.7 billion in sales in 2025 and for nearly half of Merck\u2019s revenue. In fact, the New Jersey-based drug giant would be making life tougher for so many cancer patients worldwide.<\/p>\n
An investigation by the International Consortium of Investigative Journalists<\/a> reveals how one of the world\u2019s largest drugmakers deployed tactics to both inflate the volume of prescriptions and keep the price high through lobbying and by seeking to delay cheaper versions of the drug from reaching hundreds of thousands of cancer patients in the coming years. This is playing out as governments around the world spend growing amounts on Keytruda, with steep prices straining government budgets, even in wealthy countries. List prices range from about $80,000 for a year\u2019s treatment in Germany to $208,000 in the U.S., $93,000 in Lebanon to about $130,000 in Colombia, $65,000 in South Africa to $116,000 in Croatia.<\/p>\n Cancer is a growing public health threat, responsible for nearly 1 in 6 deaths worldwide. Projections show cancer rates rising particularly in lower-income countries where Keytruda remains largely unaffordable. The death toll is forecast to surge by 75% to 18.6 million in 2050, with the cost of some new therapies already exceeding $1 million per patient.<\/p>\n Living with or beyond a cancer diagnosis brings about profound costs \u2014 physical, emotional and financial. Some patients are so desperate for Keytruda that they turn to the black market to get the drug for less money, though they don\u2019t know if it\u2019s the drug or a counterfeit version. Other patients seeking Keytruda face harrowing bureaucratic obstacles and end up suing their governments for access to the drug; not all of them survive long enough to learn the court\u2019s ruling.<\/p>\n Reporting by ICIJ\u2019s media partners across five continents paints a picture of deep and dangerous inequity:<\/p>\n In India, families seeking Keytruda rely on a frayed safety net \u2014 poor insurance coverage, Merck\u2019s patient assistance program and out-of-pocket funds. In Brazil, the world\u2019s seventh most populous country, most cancer patients can\u2019t afford Keytruda, and thousands turn to the courts to get it. In South Africa, where the vast majority of citizens are not able to afford private health care and the typical monthly income for a household is under $500, a single dose of Keytruda costs roughly 10 times as much: $4,904.<\/p>\n In the United Kingdom, research shows that Keytruda tops the list of drugs for which the cash-strapped National Health Service overpays. For some lung cancer patients, the NHS has been paying five times as much for Keytruda than it should, according to cost-effectiveness data from the University of York shared with the Bureau of Investigative Journalism, ICIJ\u2019s U.K. partner. And in Guatemala, one doctor dealing with limited access had to choose two among his many patients to receive the drug.<\/p>\n \u201cWhat\u2019s left for me to do? To play God,\u201d said Julio Ramirez, head of the oncology unit at the regional public hospital in Quetzaltenango, Guatemala\u2019s second largest city. \u201cThe first patient who arrives, that\u2019s who I\u2019m going to give the treatment to because that\u2019s all I can do.\u201d<\/p>\n The Cancer Calculus<\/a>, a yearlong investigation by ICIJ and 47 media partners in 37 countries, is based on hundreds of interviews with oncologists, cancer patients and their families, patent experts, regulators, pharmaceutical industry insiders and others, as well as exclusive pricing data and patent analyses and thousands of pages of company presentations, patent board documents, lawsuits and corporate and regulatory records. ICIJ\u2019s media partners also unearthed public health records, meeting minutes, pricing and reimbursement data, and other documents through\u00a0 1,018 public records requests in 27 countries.<\/p>\n The investigation explores how Merck, known as MSD outside the U.S. and Canada, employed aggressive but legal tactics to increase its Keytruda revenues and make the drug one of the bestselling ever \u2014 at the expense of some patients.<\/p>\n Among the project\u2019s findings, we report:<\/p>\n Merck and other cancer research businesses exploited the patent system<\/a> to build a fortress around Keytruda of at least 1,212 patent applications in 53 countries, regions and territories. This stream of follow-on patents could help Merck stifle competition and maintain high prices \u2014 and billions of dollars in revenue \u2014 for 14 years after its original patents expire in 2028. All of these strategies produce revenue for Merck, with about 60% of its Keytruda sales in the U.S.<\/p>\n An ICIJ analysis shows that Merck has generated about $163 billion in Keytruda sales since 2014, reaching more than 3 million people. The company funneled nearly $75 billion in dividends to shareholders and $43 billion into share buybacks while reducing its U.S. taxes by recording profits in lower-tax jurisdictions. In its 2025 annual report, Merck disclosed it paid around $1.6 billion in U.S. income taxes, compared with $4.5 billion in other countries.<\/p>\n<\/p>\n Davis declined to comment for this story, but Merck senior vice president Johanna Herrmann defended the company\u2019s pricing practices, saying that Keytruda\u2019s price \u201creflects its value to patients and health-care systems.\u201d<\/p>\n \u201cWe have a long history of responsibly pricing our medicines to reflect their value to patients, payers and society,\u201d she wrote in a letter to ICIJ<\/a>.<\/p>\n Herrmann acknowledged in a separate letter<\/a> that Merck faces \u201cincreasing political and business pressures\u201d over access and pricing in emerging markets. But she said the company is working to ensure health care is \u201caffordable, efficient, equitable and sustainable on a global scale.\u201d<\/p>\n In our reporting, we found that Merck\u2019s conduct was typical of the pharmaceutical industry \u2014 and that the company was not an outlier in terms of its overall business practices. But the incredible growth of and interest in Keytruda could be further pushing what is acceptable by industry standards.<\/p>\n Peter Maybarduk, director of the access to medicines group at Public Citizen, a nonprofit consumer advocacy organization based in Washington, D.C., said the pharmaceutical industry has created a system of global rules to protect drugmakers and ensure wealthy governments protect them. \u201cThere is a whole architecture underpinning Keytruda and every patented drug where the U.S. government and Europe go to bat for the industry and its rules,\u201d he said.<\/p>\n That system is marked by big questions about how the practices of Merck and the other Big Pharma companies affect the future of our collective wellness. How that plays out is often the story of putting profits over patients. For the world\u2019s haves and have-nots, it can also be the story of who lives and who dies.<\/p>\n Miracle beginnings<\/p>\n Rob Davis, 59, grew up in Franklin, Ind., a farming town 20 miles south of Indianapolis, in the shadow of Eli Lilly, one of the world\u2019s largest drug companies. He would work at Lilly for 14 years while studying for his business and law degrees.<\/p>\n When his father, Morris, an auditor, was fighting cancer, Davis went for a job interview with Merck\u2019s then-CEO Ken Frazier. At the end of their meeting, Frazier directed Davis toward an image by the door. He wanted to show him a PowerPoint slide taped to the wall, Davis said in a 2024 interview at Northwestern University\u2019s law school. It displayed different tumor types and their responses to Keytruda.<\/p>\n \u201cThis is why you need to come to Merck,\u201d Frazier told him. \u201cBecause we\u2019re going to make a real difference.\u201d<\/p>\n Davis joined Merck as chief financial officer in the spring of 2014, a few months before his father died of lung cancer at age 82. \u201cI wonder what would have happened if that drug would have been available 10 years ago when my father was going through his battle,\u201d he said in the interview.<\/p>\n As Davis settled into the new job, Merck was getting ready to launch Keytruda to treat melanoma, the deadliest form of skin cancer. Projected U.S. sticker price: about $12,500 a month, or $150,000 a year.<\/p>\n When it emerged, it revolutionized cancer treatment. In a class of immunotherapy drugs called immune checkpoint inhibitors, Keytruda shifted the focus from directly attacking tumors to empowering the immune system to fight them. Now approved in the U.S. to treat 19 types of tumors, including of the skin, lung, breast and colon, it has become a lifeline for millions, turning previously terminal forms of advanced cancer into manageable diseases and increasing survival rates for others with cancers that are hard to treat \u2014 sometimes for months, sometimes for years.<\/p>\n \u201cAll these years later I haven\u2019t stopped coming here to give thanks, for my life, for being alive,\u201d Carolina Garc\u00eda Corsini told an ICIJ reporter while at a Catholic shrine in Madrid. A former journalist and mother of three from the Spanish capital, Garc\u00eda was 37 years old and four months pregnant when she was diagnosed with metastatic melanoma in February 2011. The tumors had spread to her left breast. After securing a coveted spot in Keytruda\u2019s first clinical trial, she began traveling to Paris every few weeks to get treated. Fourteen years later, and in remission, she said, \u201cI\u2019m convinced it\u2019s a miracle.\u201d<\/p>\n Such experiences are just some of the reasons Merck is now ranked No. 65 on the Fortune 500, with its Keytruda revenues greater than McDonald\u2019s or the entire National Football League.<\/p>\n Today, as Merck\u2019s CEO and chairman and head of the powerful trade lobby PhRMA, Davis promotes key pillars of the industry agenda: that patent protection and high prices help drug companies recover the billions spent developing new medicines and getting them to patients safely on a mass scale. The process typically takes a decade or more, and a U.S. patent, which generally lasts 20 years from the application date, allows companies to enjoy a dominance in the market, charge higher prices, recover research and development costs and earn profits to fund future research. From 2011 to 2023, Davis said in 2024 congressional testimony, Merck invested $46 billion to research, develop and manufacture Keytruda. He cited more than 2,200 clinical trials \u2014 conducted by Merck and other researchers \u2014 to study Keytruda, and the company plans to invest another $18 billion in Keytruda clinical studies into the 2030s.<\/p>\n \t
Keytruda, known generically as pembrolizumab, is a type of immunotherapy that restores the body\u2019s ability to fight cancer cells. Unlike chemotherapy, which targets rapidly dividing cancer cells, Keytruda disrupts a process that allows some cancers to circumvent the immune system.
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That process involves a protein called PD-1, which is found on the surface of some white blood cells. (White blood cells regulate the body\u2019s immune response.) But some cancer cells express proteins called PD-L1 or PD-L2 that bind to PD-1 and block the body\u2019s ability to recognize and kill cancer cells.<\/p>\n
<\/p>\n Keytruda works by attaching to PD-1, preventing it from interacting with the cancerous cells\u2019 proteins and allowing the immune system to detect and attack the cancer.<\/p>\n
<\/p>\n Pembrolizumab was first invented in the early 2000s by Dutch scientists working for a company that was later acquired by Merck. The drug was approved for medical use in the U.S. in September 2014.<\/p>\n
But a new analysis by Public Eye<\/a>, a Swiss-based nonprofit advocating for corporate accountability, estimates Keytruda\u2019s R&D costs at $1.9 billion \u2014 1% of the drug\u2019s global revenue since its launch in 2014. Adding the cost of failed clinical trials, the R&D estimate is $4.8 billion, or 3% of the drug\u2019s revenue. Patrick Durisch, Public Eye\u2019s pharma specialist, said he based his numbers on a review of Keytruda clinical trials and their average costs<\/a>, which are the largest share of R&D expenses.<\/p>\n Davis\u2019 figures are \u201cabsolutely unverifiable,\u201d Durisch told ICIJ. \u201cMerck could throw any figure they want \u2014 as high as possible to justify the exorbitant price tag.\u201d<\/p>\n \u201cThe share of R&D costs in relation to the price of a vial is very tiny and they have long been recouped,\u201d he added. \u201cThe price is thus excessively high, not to cover the R&D costs or hedge risks but to make maximum profits.\u201d<\/p>\n Nathan Cherny, an oncologist and director of cancer pain and palliative medicine at Shaare Zedek Medical Center in Israel, said a \u201cperfect storm\u201d led to the high cost of Keytruda. It began in 2003 when the U.S. Congress passed a \u201cnon-interference\u201d clause as part of the Medicare law, requiring the government to go along with manufacturers\u2019 list prices for new drugs without any price negotiations. Although the clause barred the federal government from negotiating prices, its supporters framed it as a reinforcement \u2014 not a suspension \u2014 of market forces by shifting negotiating power to private plans rather than the government.<\/p>\n \u201cIt was a suspension of market forces,\u201d Cherny told ICIJ. And its impact was felt worldwide.<\/p>\n A \u2018Wild West\u2019 of drug development<\/p>\n The Keytruda promotion campaign was in its second year when an extraordinary development led to a public relations bonanza. In 2015, Jimmy Carter\u2019s doctors used Keytruda successfully to treat the former U.S. president\u2019s lethal skin cancer, which had spread to his liver and brain when he was 91. Patients clamored for \u201cthe president\u2019s drug.\u201d And Carter lived to 100.<\/p>\n For Keytruda\u2019s business plan, Merck relied on strategies straight out of a pharma playbook that took hold in the United States and spread internationally. It used taxpayer-funded research, confidential pricing strategies and regulatory shortcuts, which allowed Merck to gain earlier market entry and sell Keytruda at high prices \u2014 even before full clinical evidence was available. Merck said Keytruda received 19 accelerated approvals in the U.S \u2014 under a special regulatory program designed to expedite development of new drugs for serious or life-threatening conditions. But this type of approval faces controversy because of how early the drugs enter the market, their frequently high costs and sometimes weak clinical evidence. Merck, for example, withdrew two Keytruda treatments that won accelerated U.S. Food and Drug Administration approval, because they failed to produce sufficient benefits. Merck insists it has been judicious in its use of the program.<\/p>\n Our investigation also shows how Merck took advantage of the orphan drug designation, a category that gives incentives to companies to develop drugs for rare diseases. Merck gained nine separate orphan designations for Keytruda.<\/p>\n Another Merck practice that is expanding globally is funding patient groups that advocate for insurance coverage, lobby governments and support faster regulatory approvals. Merck also pours money into payments for doctors and other health care professionals. In the U.S. alone, records show, Merck spent nearly $52 million on Keytruda-related fees to health care professionals from 2018 to 2024, with five doctors receiving more than $1 million apiece.<\/p>\n Merck has said that these types of payments help inform the health care community about Keytruda, which in turn improves patient care. But a U.S.-based study performed for the National Bureau of Economic Research found that prescribing physician-administered cancer drugs like Keytruda increased by 4% in the 12 months after a health care professional received funds from a drug company. Those payments \u2014 covering meals, travel, research, consulting, and speaking fees \u2014 led to more spending by doctors on cancer drugs but no improvements in patient survival, the study found.<\/p>\n The payments to patient groups were no less notable. In the U.S., Merck paid tens of millions of dollars to patient advocacy groups between 2017 and 2025. In Belgium, the newspaper De Tijd discovered that a dozen patient groups and cancer care advocacy organizations received about $1.8 million from Merck\u2019s Belgian subsidiary between 2022 and 2024. Some of them also lobbied for positions aligning with the company\u2019s\u00a0push for expanded patient access to its cancer drugs and additional public subsidies. In response to questions from De Tijd, several organizations insisted they work independently of pharmaceutical companies and do nothing in exchange for their financial support.<\/p>\n Merck defended such practices. \u201cWe are explicit that any collaboration or funding involving patient organizations is entirely independent of health technology appraisals and could not be construed as an inducement to prescribe, recommend, or appraise a medicine,\u201d the company said in a statement to ICIJ.<\/p>\n By 2021, senior scientists inside the FDA were voicing concern about the explosive growth in immunotherapy, dominated by Keytruda. Richard Pazdur, then head of the FDA\u2019s unit working to improve the development of cancer drugs, and Julia A. Beaver, then the FDA\u2019s chief of oncology, wrote in the New England Journal of Medicine in December 2021 that \u201cThe unbridled and rapid growth of checkpoint inhibitors has led to a Wild West of drug development, featuring a stampede of commercial sponsors, clinical trials and redundant development plans.\u201d They decried the increasingly crowded and frantic market that, in their view, led to too many clinical trials, redundant treatments, inefficient use of resources and too many diagnostic tests to select patients.<\/p>\n Immunotherapy, while offering life-changing and sometimes miraculous results for a small number of cancer patients, failed to help many others, and some complained that doctors downplayed risks.<\/p>\n Keytruda sales ballooned globally. From 2020 to 2024, according to exclusive sales data shared with ICIJ by IQVIA Institute for Human Data Science, there was a 232% increase in France to $2.8 billion; 265% in Brazil to $753.7 million; 491% in Mexico to $137.3 million; and 584% in T\u00fcrkiye to nearly $100 million.<\/p>\n<\/p>\n The changed landscape raised new questions for oncologists and insurers: Which treatments work for which patients? What are the proper doses, frequency of treatment and duration of treatment? And how should they assess the value of all the new treatments?<\/p>\n Wolf-Dieter Ludwig, an oncologist who chaired the German Medical Association\u2019s drug commission for 18 years, cited Keytruda as an example of \u201cwhere too much money is being spent in our health care system.\u201d The medicine has made a significant difference in some types of cancers, he told ICIJ\u2019s partners at Paper Trail Media, but added that it rarely leads to a cure, and the high price is not justified. Pharmaceutical companies often use the term \u201cgame changer,\u201d Ludwig said, but it is, above all, about one thing: good marketing.<\/p>\n Extreme prices, extreme secrecy<\/p>\n Keytruda\u2019s rapid revenue growth was ultimately due more to the rising number of patients treated and prescriptions filled than to an increase in prices, according to an analysis performed for ICIJ. Pharmaceutical spending, fueled by drugs such as Keytruda, reached record highs in the 2020s. Merck says it prices its products differently across markets, and sometimes within markets, to ensure they reach as many patients as possible.<\/p>\n But as the global crisis over skyrocketing drug prices intensified, Davis expressed concern about cancer patients\u2019 financial hardships. And there had been plenty of hardship. Since Keytruda came to market in 2014, ICIJ found 632 cases in which patients in 51 countries turned to GoFundMe and other crowdfunding sites to raise money for Keytruda treatments.<\/p>\n \u201cWe need to focus efforts on reducing out-of-pocket cost,\u201d the Merck chief executive told investors at a health care conference in 2021. \u201cThat is the focal point.\u201d<\/p>\n ICIJ\u2019s investigation found that Merck\u2019s list prices, or the initial undiscounted prices, vary wildly across countries, ranging from about $850 for a single 100 mg vial in Indonesia to $6,015 for the same vial in the U.S.<\/p>\n Extreme disparities stem from secret discounts and rebates applied to list prices in different countries as well as the different ways health care systems decide drug costs. There\u2019s no price cap for most prescription drugs in the U.S., for example, where drug manufacturers set prices largely on their own. In many other countries, governments negotiate with drugmakers to set a price.<\/p>\n A common feature of drug-pricing systems worldwide: They thrive on secrecy. At least half a dozen authorities around the globe refused to disclose to ICIJ and its media partners public spending details about Keytruda or the number of patients receiving the medicine. They cited an array of explanations \u2014 for example, that they or Merck had deemed the information a \u201ctrade secret.\u201d<\/p>\n Despite the extreme secrecy, ICIJ obtained and compared Keytruda list prices and the drug\u2019s maximum sales prices in 31 countries. ICIJ found big differences in affordability, with Keytruda comparatively less affordable in poorer countries. In South Africa, for example, Keytruda\u2019s list price (excluding taxes and fees) is about $3,800 for a 200 mg dose \u2014 a third of the U.S. list price. Still, Keytruda is far less affordable in South Africa, where a person earning the median income can\u2019t even buy one dose in a year, while in the U.S. a patient earning the median income can afford fewer than five doses.<\/p>\n At the same time, according to ICIJ\u2019s analysis, Americans with the median income can afford less Keytruda than those earning the median income in some wealthy European countries, such as France and Belgium. In poorer Eastern European countries like Bulgaria and Hungary, Keytruda tends to be less affordable than in more affluent Western Europe, ICIJ\u2019s affordability comparison shows.<\/p>\n And in Mexico and several other Latin American countries, sticker prices for Keytruda tend to be higher \u2014 when adjusted for economic levels \u2014 than in wealthier countries, ICIJ\u2019s investigation shows.<\/p>\n In Guatemala, Alberto Xum thought, like many cancer patients in Latin America, that he would have to forgo treatment altogether. A one-year supply of Keytruda vials costs $180,000 or more in the Central American country, and Xum, a 65-year-old uninsured artisan, sells leather souvenirs in a region where the average monthly household income is around $700. Diagnosed with metastatic kidney cancer in 2022, Xum told his oncologist, Julio Ram\u00edrez, that he was ready to give up treatment after being prescribed pills that cost $1,900 every three months. Xum was able to pay just one time.<\/p>\n \u201cI told the doctor I couldn\u2019t afford it,\u201d he said. \u201cI was putting my life in God\u2019s hands.\u201d<\/p>\n To Xum\u2019s great fortune, though, Ram\u00edrez was about to receive authorization from the health ministry for one of the first Keytruda treatments at his hospital. Xum was the chosen one. Every three weeks for the next two years Xum rode a bus for 2\u00bd hours from his rural town, Samayac, to the public hospital in Quetzaltenango to receive the $11,000 infusion, paid for by the government.<\/p>\n \u201cSometimes I ask, \u2018Who am I to deserve all this luck?\u2019 \u201d Xum told ICIJ. His tumors had shrunk, but he was not in remission.<\/p>\n Now a new study supports ICIJ\u2019s findings and raises fresh concerns about Keytruda\u2019s affordability and access. Treatment for six months of Keytruda for head and neck cancer costs nearly 80 times the average monthly income in India and 43 times the average in Pakistan. The cost remained catastrophically high in wealthy countries too \u2014 nearly six times the average monthly income in the U.S. and nine times the average in the U.K., according to the study<\/a>, published in February in an oncology specialty journal. In short, six months of Keytruda ranges from $7,676 in Bangladesh to $38,254 in Australia, the researchers found, concluding, \u201cModern immunotherapies remain economically inaccessible across most settings.\u201d<\/p>\n ICIJ found Keytruda treatment costs for patients are particularly chaotic in the U.S. Data compiled by Serif Health, a San Francisco firm that analyzes health care reimbursement information, shared data with ICIJ showing that patient and insurer costs vary dramatically. Across the U.S., estimated costs range from $5,858 to $43,800 for a typical 200 mg Keytruda treatment, depending on where the drug is given, which commercial insurance company and provider are involved and how it\u2019s billed.<\/p>\n For Barbara Thornton, a 64-year-old home health aide from Cincinnati, Ohio, who recently overcame pancreatic cancer, Keytruda treatments at a nearby hospital\u2019s outpatient center cost well above the list price.<\/p>\n Each treatment at the infusion center came with a bill of about $42,000, Thornton told ICIJ\u2019s partners at USA Today. A combination of her husband\u2019s insurance, financial assistance from her hospital system, and Medicaid covered the majority of her portion of the costs.<\/p>\n \u201cI was lucky. I had insurance,\u201d Thornton said. \u201cWe\u2019re not living the high life \u2014 let me put it that way \u2014 so we qualified for financial assistance.\u201d<\/p>\n Thornton received Keytruda intravenously for 27 months. When her treatment ended, she rang the bell at her center last December, marking the milestone and her transition to cancer survivor.<\/p>\n![\"Photo](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Quetzaltenango_Cancer-17-Plaza-Publica-1138x640.jpg\")
\n Cancer patients receiving treatment in the oncology unit at the public hospital in Quetzaltenango, Guatemala. Image: Laura Garcia \/ Plaza P\u00fablica <\/p>\n
\nMerck has promoted a higher dosage of Keytruda than is necessary, some leading cancer researchers say. And that dosage could cost the world an estimated $5 billion just for lung cancer patients by 2040, according to researchers at the World Health Organization.
\nThe drug giant has taken advantage of industry regulatory shortcuts, helped orchestrate a costly global lobbying campaign\u00a0and operated with a gross lack of transparency in pricing. It has distributed tens of millions of dollars in the U.S. in consulting fees, travel costs and other Keytruda-related payments to doctors and health-care professionals.<\/p>\n![\"Merck](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Rob-Davis-GettyImages-1988736277-1138x640.jpg\")
\n Robert Davis, chief executive officer of Merck, speaks during a Senate Health, Education, Labor, and Pensions Committee hearing on drug prices in Washington, D.C., in February 2024. Image: Tierney L. Cross\/Bloomberg via Getty Images <\/p>\n![\"Photo](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Keytruda-Carolina-Garcia-with-daughter-Cristina-supplied-540x640.jpg\")
\n Carolina Garc\u00eda Corsini, right, with her daughter, Cristina in 2023. Carolina was pregnant with Cristina when she was diagnosed with cancer, but went into remission after successful treatment with Keytruda. Image: Supplied <\/p>\n
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\n Former President Jimmy Carter, pictured here in 2023 at age 99, boosted Keytruda\u2019s public profile after his successful treatment for cancer when he was 91 years old. Image: Alex Brandon – Pool\/Getty Images <\/p>\n![\"Photo](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Quetzaltenango_Cancer-patients-treatment-Plaza-Publica-1138x640.jpg\")
\n Cancer patients in a clinic in Quetzaltenango, Guatemala, receiving treatment. Image: Laura Garcia \/ Plaza P\u00fablica <\/p>\n![\"Alberto](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Alberto-Xum-Quetzaltenango_Cancer-22-Plaza-Publica-1138x640.jpg\")
\n Alberto Xum, 65, said he couldn\u2019t afford treatment after he was diagnosed with cancer in 2022. But he got lucky \u2014 a government program paid for Keytruda for him. Image: Laura Garcia \/ Plaza P\u00fablica <\/p>\n![\"Two](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/04\/Barbara-Thornton-Phil-Didion-Enquirer-1138x640.jpg\")
\n Barbara Thornton received multiple Keytruda infusions to help treat her pancreatic cancer. Image: Phil Didion \/ The Cincinnati Enquirer <\/p>\n
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