New TB treatment for developing nations priced at $1,040

A newly-approved three-drug treatment for tuberculosis will cost more than twice the amount previously proposed by advocacy groups for other treatments. 

The United Nations-backed Stop TB Partnership said on Monday that BPaL – priced at $1,040 for a complete regimen – would be available in 150 countries through the Global Drug Facility (GDF), a global provider of tuberculosis medicines created in 2001 to negotiate lower prices for treatments.

Tuberculosis was responsible for 1.5 million deaths in 2018, according to the World Health Organization (WHO).

BPaL is an oral treatment which promises to be the shorter and more convenient choice compared with existing tuberculosis treatment options, which use a cocktail of antibiotic drugs over a period of up to two years.

The new cocktail, which will treat extensively drug-resistant strains of the illness, consists of drug developer TB Alliance’s newly-approved medicine pretomanid, in combination with linezolid and Johnson & Johnson’s (J&J) bedaquiline.

Pretomanid, which will be available at $364 for a treatment course, is only the third new medicine for drug-resistant tuberculosis to be approved in about 40 years, after J&J’s bedaquiline and Otsuka Pharmaceutical Co Ltd’s delamanid.

Advocacy groups have long criticised the cost for bedaquiline and delamanid. NGO Doctors Without Borders (Medecins Sans Frontieres, or MSF) has waged a running battle in public with J&J over its $400 price tag for a six-month course for bedaquiline.

MSF has argued that bedaquiline could be produced and sold at a profit for 25 cents a day, and that the price of treatments for drug-resistant tuberculosis should be no higher than $500 for a complete treatment course.

However, Stop TB Partnership says the costs of other regimens for extremely drug-resistant tuberculosis range from $2,000 to $8,000 for courses of at least 20 months.

TB Alliance in April granted a license to United States drugmaker Mylan NV to manufacture and sell pretomanid as part of certain regimens in high-income markets, as well as a non-exclusive license for low-income and middle-income countries, where most tuberculosis cases occur.

Stop TB Partnership said it would start supplying the regimen following WHO’s guidance on using the drug. Mylan, however, said it will also sell the drug directly to countries.

Prices in low-income countries would be in-line with the price offered through GDF, but would be decided on a case-by-case basis where the drug is not supplied through GDF, it said.

The drug will be available in bottles of 26 tablets, with a six-month treatment requiring seven bottles.