Global push to thwart TB sees Sanofi slash price of key drug

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A pharmaceutical multinational slashed the price of a key anti-tuberculosis drug boosting the battle against the world’s deadliest infectious disease, as a new treatment was also set to begin extensive testing. Eyewitness News report the initiatives came as the UN seeks to galvanise the campaign against TB, which killed 1.5m people worldwide last year and saw 10m more infected.

“This lifesaving drug has, until now, been completely unaffordable in developing countries,” said Lelio Marmora, head of UNITAID, a global health initiative that helped broker the landmark deal, which will see the Sanofi company cut the price of its rifapentine drug by two thirds.

The report says the cheaper price will apply in 100 of the world’s poorest nations. South Africa, where TB is a big killer, will roll out the drug from next year, UNITAID’s programme director Robert Matiru said. Other major markets that could take up the treatments include India, which has a quarter of the world’s TB cases, Indonesia, Philippines and Kenya, Sanofi‘s global health business chief Thibaud Lefort said. “We are looking realistically next year at adding at least five major countries and a dozen other smaller countries accelerating their efforts,” he said.

Lefort said his firm welcomed generic versions of the drug being produced.

Rifapentine, combined with the drug isoniazid, not only treats patients with TB, but also shields a person who is infected but not yet sick from developing the disease. With one-quarter of the world’s population carrying the TB infection, and up to 10% of them going on to develop the chronic lung disease, experts say preventive drugs such as rifapentine are central to eradicating the illness.

The deal involved a procurement commitment for the drug, rifapentine, from UNITAID and the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2020, Matiru, is quoted in Devex as saying. To secure the almost 70% price reduction for the drug, UNITAID and the Global Fund committed to procure the drug for at least 300,000 patient treatments in 2020, he said.

“It was important for us to agree on the target threshold of treatments to be supplied next year for (Sanofi) to have confidence that the product would actually be introduced and rolled out, to enable them to realize economies and to offer such a price reduction,” he explained.

The deal follows in the footsteps of the high-level meeting on TB last year in New York, where UN member states agreed on a political declaration that called for greater commitment to ending TB by 2030.

As part of the deal, the drug rifapentine will be available to 100 countries for $15 – a significant reduction from its current cost of approximately $45, although that doesn’t include other related costs such as transportation. The steep price tag has kept most countries from using it in their preventive TB interventions, despite its promise of a shorter treatment course.

The report says 100 eligible countries account for more than 90% of the global need for preventive therapy for latent TB infection, according to UNITAID. Covering countries with the highest burden of TB, and TB and HIV co-infection, was part of the priority.

“There are those out there who argue that the eligibility should have been higher; let’s say 140, 150 countries. And we don’t disagree. However, this is a very important starting point, and what it recognises is, pragmatically, not all countries are going to be in a position to start moving completely with roll out next year,” Matiru said.

“But UNITAID in subsequent agreements, particularly with generic companies, we’ll be looking to expand the eligibility so that countries, once they’re ready to move a bit later, certainly can access a price as good as, if not better than, $15,” he said.

The lower price of rifapentine will be accessible to international funders with TB programming, such as the Global Fund, the Global Drug Facility and the US President’s Emergency Plan for AIDS Relief, as well as large international NGOs such as Médecins Sans Frontières, which are likely to cover the “lion’s share of procurement” of the drug, Matiru said.

Small NGOs are “not ineligible,” but requests will be taken on a case-by-case basis, ensuring Sanofi can manage the number of buying parties, he said. “But the key factor is that they’re buying on behalf of eligible countries,” said the UNITAID official.

UNITAID and partners hope to bring two generic manufacturers into the market in the next two years, to up the supply of rifapentine as more countries are expected to roll out the regimen and to drive competition.

There were 186,772 notified cases of MDR-TB or rifampicin-resistant TB in 2018 – up from 160,684 in 2017 – according to the latest global TB report by the World Health Organisation. While there’s been an increase in the number of cases enrolled for treatment – to 56,071 from 139,114 in 2017 – there are still fewer people receiving treatment. In 2018, that was just 32% of the estimated case incidence of 484,000.

Eyewitness News report Devex report

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