With the World Health Organisation (WHO) updated recommendations for improved drug-resistant tuberculosis (DR-TB) treatment, prioritising the use of several oral drugs, including bedaquiline, Doctors Without Borders (MSF) has called on producers to make the drug more affordable.
The international medical humanitarian organisation welcomed the WHO recommendations and said the newly recommended 18- to 20-month treatment regimen could help improve cure rates, decrease mortality and have far fewer side effects.
But for the recommendations to be put in place and for many more people with DR-TB to receive treatment, MSF called on US pharmaceutical corporation Johnson and Johnson (J&J) to take immediate steps to make the drug affordable, in particular in low- and middle-income and high DR-TB burden countries.
MSF says only 20% of people with DR-TB globally receive the treatment they need.
Although J&J recently announced a price reduction for bedaquiline in some countries, it falls short in making the drug affordable in countries that are hardest hit by DR-TB.
The reduced price of almost R6 000 for six months of treatment that certain countries are promised remains excessive, says MSF.
In countries excluded from J&J’s price reduction, the corporation charges between about R43 000 and close to R500 000 for six months of treatment.
To facilitate treatment scale-up, MSF has called for a full DR-TB treatment regimen to be priced no higher than around R7200. MSF also supports the call from HIV and TB activists asking J&J to cut the price of bedaquiline to $32 (R468) a month or $192 for six months, across all low- and middle-income and high DR-TB burden countries.
“Governments and treatment providers should urgently make sure people can access optimal treatments, including bedaquiline,” said MSF’s international medical secretary Dr Mercedes Tatay.
To ensure the long-term affordability and sustainable supply of bedaquiline, which is patented quite widely until 2023, MSF called on J&J to also issue a licence to the Medicines Patent Pool, which would enable access to affordable generic versions of the drug.
High TB burden countries should also consider issuing a “government use” licence for bedaquiline to encourage price-lowering competition among generic producers before the patent expires.
MSF additionally urged J&J and its Russian partner Pharmstandard, responsible for supply in Eastern Europe and Central Asia, to work swiftly to register the drug, particularly in the 10 out of 30 high DR-TB burden countries where it remains unregistered.
The WHO deputy director-general for programmes, Dr Soumya Swaminathan, said the treatment landscape for patients with multidrug-resistant TB (MDR-TB) would be dramatically transformed for the better.
“Building on the available new data, and with the involvement of a large number of stakeholders, WHO has moved forward in rapidly reviewing the evidence and communicating the key changes needed to improve the chances of survival of MDR-TB patients worldwide. Political momentum now needs to urgently accelerate,” Swaminathan said.