MSF: TB test price reduction is a step in the right direction

Cepheid and its parent company Danaher announced today that they are reducing the price of the Xpert MTB/RIF test for TB by 20 percent in high-TB-burden countries.

An MSF team surrounded by patients is working around a table surrounded by tuberculosis medication in Tondo, Manila.

Philippines 2023 © Ria Kristina Torrente/MSF

NEW YORK/GENEVA, SEPTEMBER 19, 2023—Following renewed activism by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) and other tuberculosis (TB) advocates over the last week, Cepheid and its parent company Danaher announced today that they are reducing the price of the Xpert MTB/RIF test for TB by 20 percent—from $9.98 to $7.97 per test—in high-TB-burden countries. While this is an important step in the right direction, Cepheid and Danaher must now reduce the price of the Xpert MTB/XDR test that is used to diagnose the most severe form of TB, which is currently priced at $14.90, as well as tests for other diseases, said MSF.

The GeneXpert diagnostic testing technology produced by Cepheid has revolutionized TB testing since entering the market in 2010. However, because of the high prices that Cepheid has been charging for the GeneXpert tests, scaling up TB testing to all people who need it has remained a challenge and has forced many TB care providers to rely on cheaper but less sensitive testing using microscopes, a method developed in the 1800s. MSF analysis has estimated that it costs Cepheid less than $5 to manufacture one GeneXpert TB test, while Cepheid has been charging MSF and high-burden low- and middle-income countries double and triple that price per TB test for years. For the last ten years, the companies have refused to lower their TB test prices.

TB remains the top infectious disease killer with approximately 10.6 million new cases and 1.6 million deaths in 2021. Only approximately one-third of people with drug-resistant TB (DR-TB) were able to access treatment, with the majority of people remaining undiagnosed and therefore untreated.

Stijn Deborggraeve, diagnostics advisor for MSF’s Access Campaign, said of today’s announcement:

“Today’s price announcement by Cepheid and its parent corporation Danaher is an important step in the right direction and comes after years of public pressure to reduce the price of the TB Xpert tests. We commend the activism and enthusiasm of the global coalition of civil society and TB activists that escalated the ‘Time for $5’ campaign over the last week and made this important price reduction happen.

“More than one in three people with TB go undiagnosed, and undiagnosed TB kills people, so having more affordable tests will allow treatment providers and governments to test more people and offer them the treatment they need to stay alive and get healthy again.

“While the announced price reduction is timely and critical, we regret that Cepheid and Danaher have chosen to still charge $14.90 for the XDR-TB test, which is used to diagnose the deadliest form of TB. The price of this particular test remains more than triple what it costs Cepheid to produce a single test cartridge, according to an independent analysis commissioned by MSF in 2019 that identified the production costs to be between $3 and $4.60 per test.

“With the high volumes of GeneXpert tests being purchased by governments and treatment providers in low- and middle-income countries, economies of scale should continue to bring the production costs down, and Cepheid and Danaher must pass along these savings to people in affected countries. In addition, Cepheid did not develop the GeneXpert testing technology alone but instead benefitted from at least $250 million in public money to develop the GeneXpert test.

“Cepheid and Danaher have stated that with this price reduction the corporations will now be selling the MTB/RIF TB test ‘at-cost,’ so MSF invites the company to be fully transparent and make the production cost of GeneXpert tests public.

“We urge Cepheid and Danaher to make further price reductions for the test to detect XDR-TB and the tests for other diseases to make a meaningful difference in the lives of more people in low- and middle-income countries.”