My mother, Zuleikha Bangsajayah, was diagnosed with Marginal Zone None Hodjkin Lymphorma in the Thyroid. Following the surgery, her surgery doctor, Dr. Jagath Mallawa, recommended a Hemato-Oncologist named Dr. Devinda Jayathilake to manage the condition. He requested a PET scan and a second opinion on a biopsy that was not conclusive. Once the situation was confirmed, Dr. Devinda decided to treat her with a 4-course Rituximab 500mg treatment done weekly.

Disclaimer: I am no medical expert or affiliated with the listed companies. This includes my initial reactions and personal research done to decide among the three brands to treat my mother's condition.

Background

Rituximab is used to treat a variety of blood cancers, including non-Hodgkin Lymphoma, chronic lymphocytic leukemia, and various autoimmune diseases. It was approved for medical use in 1997 and is considered an "Essential Medicine" by the World Health Organization.

Marginal Zone non-Hodjkin B-Cell Lymphoma is a rare type of blood cancer that develops in the "marginal zone" of lymphoid tissue. Its treatment is handled by Hemato Oncologists like Dr Devinda Jayathilake.

Rituximab should be kept frigerated between 3~8℃ (and should not be frozen). So, I get it delivered to the hospital right before the infusion starts.

MabThera / Rituxan

MabThera (also Rituxan) is the original Rituximab antibody treatment approved for treatment in 1997. Biogen and Greentech market the drug in the USA while. Roche handles international marketing. Everyone smart enough to do a Google search to land on this page knows about Roche, so I will not investigate the details.

• MabThera 500mg
• Price: 380,129.75 (LKR)
• Manufacturer: Roche
• Details: www.roche.com

RituxiRel

The Reliance Life Sciences pharmaceutical company from India manufactures and markets a Rituximab drug named RituxiRel. The company is operated under the investment arm of the Reliance Group, led by Mukesh Ambani. Reliance Life Sciences is expanding in India with its 2500-acre production, research, and development facility.

• RituxiRel 500mg
• Price: 50,000/= (LKR)
• Manufacturer: Reliance Life Sciences (India)
• Importer: ABC Pharma
• Details: www.rellife.com

Rilast

Rilast is manufactured by Hetero Bio Pharma and imported and distributed by George Steuart Health (formally chaired by Dilith Jayaweera during the COVID-19 pandemic).

• Rilast 500mg
• Price: 109,600/= (LKR)
• Manufacturer: Hetero BioPharma (India)
• Importer: George Steuart Health

Note: If you do a Google search for "Hetero BioPharma", the Google business listing on the right will show what seems to be an office in a slum. This prompted a deeper dive. I noticed the company had many locations and very decent locations. However, I discovered that Hetero Healthcare, a company with more followers on LinkedIn (51K vs. Hetero Biopharma's 13K), has a product (named MABALL) at a similar price to RituxiRel in IndiaMart. Relast was not available on IndiaMart for price comparison.

Summary

I was initially inclined to go ahead with Rilast. It had a good website and was placed at the midpoint of the three contacts provided by Dr. Devinda Jayathilake. While I could afford the more expensive MabThera, the money is better spent on making her life comfortable. However, she preferred RituxiRel, the cheapest option, so I decided to do some research. The result was we chose Reliance Life Sciences RituxiRel. As of today, we have undergone two infusions. The side effects are consistent with Rituximab treatment, which was documented for Roche's MabThera/Rituxan. I can only hope we made the right choice. If quality control is reasonable, there shouldn't be a difference in theory.

I am no health expert. But I have traveled the path with my uncle's (former BoC Area Manager Mr. Azzam Bangsajayah) soft-tissue sarcoma and, currently, Mum's Marginal Zone B-cell lymphoma of the Thyroid. If you want to chat to echo some ideas, please find me on Twitter, Facebook, or WhatsApp (social links/icons below my Bio).