Médecins Sans Frontières (MSF) has called on the TB Alliance (TBA), a non-profit TB drug development organisation, and its commercial partner pharmaceutical corporation Mylan, to further lower the price of pretomanid drug, as it is just one part of a regimen of multiple drugs that people need.
The Global Drug Facility has just announced a price of US$364 for a six-month treatment course of pretomanid, only the third new drug developed for TB in half a century. Pretomanid was approved for use by the US Food and Drug Administration in August 2019. Pretomanid was developed by the TB Alliance, a not-for-profit organisation, funded by governments (e.g. Australia, Germany, the UK and the US) and philanthropic sources. It is the first TB drug to be developed and approved as part of a ready-to-use treatment regimen (BPaL: bedaquiline + pretomanid + high-dose linezolid) for people with extensively drug resistant (XDR)-TB, treatment-intolerant, or nonresponsive multidrug-resistant pulmonary TB. This new regimen has the potential to dramatically shorten treatment length to six months, greatly reduce the number of pills required, and helps increase XDR-TB cure rates from the abysmal 39%.
In light of the price reduction announcement, the lowest global price for a 6-month course of BPaL regimen is US$1,040, which is double what MSF is calling for. MSF has been calling for the price of a complete DR-TB treatment course to be no higher than $500 per person.
Researchers from the University of Liverpool have estimated that generic versions of pretomanid could be produced and sold at a profit for less than $1.35 a day, or less than $35 a month, a statement issued by MSF has said.
The high price of one of the other newer TB drugs, bedaquiline, at $400 for a six-month treatment course will also impede the uptake of the BPaL regimen in high TB burden countries. MSF has launched a global campaign calling on pharmaceutical corporation Johnson & Johnson (J&J) to lower the price of bedaquiline to no more than US$1 per day ($200 for six months, or half of what J&J currently charges).
Furthermore, the TB Alliance must also support or carry out research to address outstanding medical questions concerning the safety and efficacy of its drug independent of the BPaL regimen and in comparison to another drug in the same class, as well its suitability for different populations including children, pregnant women, and people living with HIV receiving the antiretroviral dolutegravir, the statement has said.