Patents lie at the heart of the biologics and biosimilars debate, acting both as shields for innovation and barriers to access. Biologics, being complex medicines derived from living systems, are often surrounded by a dense web of overlapping patents commonly referred to as “patent thickets.” These patents don’t just protect the drug itself but also cover manufacturing processes, formulations, and delivery mechanisms, making it difficult for biosimilar manufacturers to enter the market. Innovator companies further extend their monopoly through evergreening, filing secondary patents on minor modifications to prolong exclusivity even after the primary patent expires. While such practices safeguard investments and encourage research, they also delay the arrival of affordable biosimilars, keeping prices high and limiting patient access. This tension between protecting innovation and ensuring affordability is what makes the patent puzzle so critical in shaping India’s biopharma future.