SA pays high price for TB drugs
The prices of these drugs are already high, but compared to the prices negotiated by MSF International, the South African government was paying up to three times more for these already pricey medicines.
The MSF report that was released on the eve of World TB Day further reveals that over the last decade, roughly five million people developed drug-resistant TB (DR-TB), of which barely 0.5% had access to appropriate treatment and 1.5-million died.
There are several reasons for this state of affairs, but the MSF report, DR-TB drugs under the microscope, focuses primarily on the limited availability and high cost of quality-assured second-line medicines.
Investigations found that some of the DR-TB drugs come at extremely high prices ‘ meaning that one patient’s 24-month treatment course can range from nearly U$4 500 to almost U$9 000 ‘ almost 475 times more than a U$19 treatment course for standard, non-DR-TB.
It was also found that in recent years prices have actually been increasing as some manufacturers put an end to subsidies that have kept prices lower.
Also, despite the high global DR-TB prevalence there is a low demand for treatment – only 19 000 patients with DR-TB were reported to have enrolled in treatment by the end of 2009. Reporting of cases remains weak, which makes forecasting needs for DR-TB medicines difficult, the report said.
Several issues, including low demand and complex manufacturing processes, makes the market for the development and production of DR-TB drugs unattractive.
This has led to many countries being slow in scaling up DR-TB treatment because it is seen as expensive and complex.
In the case of extensively DR-TB the drug price rises to a staggering U$13 600 (R95 200).
According to the MSF report the price of DR-TB drug Amikacin 500mg has increased by a staggering 864% between July 2001 and April 2011. Kanamycin has increased by 617% in the same period and Cycloserine and Capreomycin around 300%.
Indications are that the South African public sector is paying way more than others who are also treating DR TB.
An example is PAS 4g sachets that are being sold to the South African government at R80 per sachet (daily dose) while MSF International is procuring the same drug for $3.14 (R21).
Capreomycin is being sold to MSF at $4 (R28) per 1g vial, which is the daily-recommended dose, while government is buying it at more than twice the price (R69).
All of these drugs are old, have been around for many years and have a single producer. Many are arguing that with 14 000 confirmed cases South Africa becomes a substantial market and should be in a position to procure the drugs at significantly reduced prices.
Director of South Africa’s TB programme Dr Lindiwe Mvusi agrees that the country is paying too much for DR-TB drugs, but that she hopes to remedy it in the next tender which is imminent.
She said South Africa would use the information on the significantly reduced prices paid by organisations such as MSF to leverage reductions.
‘It is not ideal to have so few suppliers as there is no competition, so we can only hope that this will change,’ she said.
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Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews
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SA pays high price for TB drugs
by healthe, Health-e News
March 23, 2011