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The Guardian - UK
The Guardian - UK
World
Kaamil Ahmed

Cost of tuberculosis treatment halved in deal to permit generic versions

Johnson & Johnson’s Sirturo, the branded version of bedaquiline.
Johnson & Johnson’s Sirturo, the branded version of bedaquiline. Photograph: Oksana Parafeniuk/Courtesy of MSF

The cost of a crucial tuberculosis treatment has been halved after an agreement was made to allow the sale of generic versions of the drug.

Johnson & Johnson’s price for bedaquiline, considered the backbone of treatment for drug-resistant TB will drop from $289 (£227) to $130 for a six-month course until December 2024.

Johnson & Johnson had previously been the only supplier of bedaquiline but in July agreed to allow generic versions to be supplied to poorer countries.

The move allows the Stop TB Partnership’s Global Drug Facility (GDF), the world’s largest procurer of TB medicines and diagnostics, to source the drug from cheaper manufacturers for 44 low and middle-income countries.

“No one should have to suffer from drug-resistant tuberculosis simply because they cannot afford treatment,” said Dr Atul Gawande, the assistant administrator of the Global Health Bureau of USAid. “This historic price reduction will broaden access to this life-saving drug and keep us on the path to end TB by 2030.”

The Indian drug manufacturer Lupin has also agreed to reduce the cost of its TB treatments by a third to $194 for a six-month course.

The Stop TB Partnership said the price reductions, announced on Wednesday, should save $8m and allow 51,000 more bedaquiline treatments to be purchased.

A Médecins Sans Frontières protest calling on Johnson & Johnson to lower the cost of bedaquiline for people with drug-resistant tuberculosis in New York in 2020.
A Médecins Sans Frontières protest calling on Johnson & Johnson to lower the cost of bedaquiline for people with drug-resistant tuberculosis in New York in 2020. Photograph: Justin Lane/EPA-EFE

While Johnson & Johnson’s main patent for bedaquiline expired in July, it had faced criticism for using secondary patents – in which small modifications are made to a product to extend a patent and prevent a product from being sold by competitors.

At the time, a J&J spokesperson said it uses money made through patents to pay for other drugs to be developed, which generic manufacturers do not usually do.

GDF’s chief, Brenda Waning, said she expected the prices to drop further as generic manufacturers improved production.

Bedaquiline is considered the key component of the World Health Organization’s recommended cocktail of treatment for multi-drug-resistant tuberculosis.

“Every person diagnosed with drug-resistant TB should be ensured access to the non-injectable, six months treatment regimen and this reduced price takes us exactly in that direction,” said Austin Arinze Obiefuna, the vice chair of the Stop TB Partnership board. However, he said he hoped further reductions could be achieved.

Dr Chukwuma Anyaike, Nigeria’s director of public health, said the price drop was well timed, as the country was planning to scale up its TB programme.

But he warned: “We still have the challenge of the financial gap required to treat the expected huge number to be identified in the TB response. I know am not speaking just for myself, but for all leaders of TB programmes in the world.”

A tuberculosis patient receives medical treatment at a hospital in Peshawar, Pakistan.
A tuberculosis patient receives medical treatment at a hospital in Peshawar, Pakistan. Photograph: Bilawal Arbab/EPA

Médecins Sans Frontières (MSF) welcomed the price cut but said Johnson & Johnson should drop its secondary patents, as the deal did not cover a number of countries with high burdens of TB.

Christophe Perrin, a TB advocacy pharmacist at MSF, said: “The J&J/GDF deal is still a short-term solution, as high TB burden countries in eastern Europe and central Asia – that remain excluded from the deal – will be blocked from procuring lowest-priced generics in the long run due to patent barriers.

“J&J could easily remedy this by withdrawing now its secondary patents on bedaquiline in all high-burden countries.”

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