With foreign customers in the US and Europe often willing to pay quicker and at higher margins, these companies are leveraging India’s pharmaceutical expertise to develop innovative therapies, particularly in fields like cancer treatment.
The first customers for Mestastop, a Bengaluru-based start-up developing therapies to stop cancer metastasis — the spread of cancer from the primary tumour to other organs — aren’t in India.“They’re abroad,” says founder Arnab Roy Choudhary. “For deep-tech products, awareness and understanding are much higher globally. The Indian market often waits for Western validation before embracing new technologies.”His experience reflects a broader shift. Long before commercialising products at home, a growing number of Indian biotech start-ups are generating their first revenues from customers in the US and Europe.Selling where the science pays“The economics are compelling,” says Mayur Sirdesai, Managing Partner at Somerset Indus Capital Partners. A US biotech company or contract research organisation typically pays within 30-45 days and offers gross margins of 35-40 per cent, while Indian buyers often negotiate aggressively, operate on payment cycles stretching up to six months and offer significantly lower margins.“A start-up can generate $500,000-$2 million in annual recurring revenue within two years selling globally — enough to fund hiring and R&D.”Yet commercialising abroad does not mean abandoning India.For Mestastop, global markets will remain the primary revenue driver, although Choudhary insists India remains strategically important as demand grows for high-quality, locally developed biotech products.Not every company is following the export-first route. Immuneel Therapeutics chose to commercialise in India first. “Our vision has always been India first, global next,” says CEO Amit Mookim, adding that the company wanted to prove India could develop and commercialise globally benchmarked CAR-T-Cell therapies. CAR T-Cell therapy is a type of immunotherapy that involves genetically engineering a patient’s own T Cells to attack cancer cells.Investors, however, believe the trend of exporting first reflects the industry’s evolution. Vedha Sampathkumar said Indian biotech today mirrors the SaaS boom in one important way: companies are building in India but selling globally. With the US and Europe remaining the largest markets for innovative therapeutics, start-ups are leveraging India’s pharmaceutical expertise and cost advantage to develop globally competitive products.The playbook is becoming increasingly clear: build in India, commercialise overseas and eventually bring those innovations back home.Published on July 8, 2026
