New Approach to Drug Procurement Enables More to be Treated
New York, July 19, 2001 — In a paper1 released today in the online edition of the journal Science, public health experts and scientists from the World Health Organization (WHO), Harvard Medical School, and the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) reveal how a joint approach to overcoming the global market failure to make second-line treatments for multi-drug resistant tuberculosis (MDR-TB) available in poor countries has cut the price of treatment regimens by up to 96%.
Rising at an alarming rate in many countries, MDR-TB has become a threat to the control of standard TB - a disease that kills as many as 3 million people every year. Up until now, treatment of MDR-TB has been prohibitively expensive, costing around $13,000 per patient.
The Science article, "Responding to Market Failures in Tuberculosis Control," shows how the WHO, Harvard Medical School and MSF have worked together to dramatically reduce prices for MDR-TB drugs by defining the market, negotiating bulk purchases with suppliers, and ensuring rational use of the drugs. Acting as a negotiator for all parties, MSF consolidated the various sources of demand, negotiated prices, provided advance funds for bulk purchase and assisted with technical support. The WHO has created a regulatory mechanism called the "Green Light Committee" to promote safe access to the drugs.
As a result, the price of one of the essential drugs in MDR-TB treatment, clycloserine, went down by 96% from $3.38 to $0.14. The drug is currently only available from one supplier. The cost of another drug, ofloxacin, because of competition through tendering, went down by 87.25% from $2.60 to $0.33.
"In some countries where MSF works, significant numbers of TB patients have MDR-TB, but they are not treated with drugs that could save their life because the cost is around $13,000 per patient," says Bernard Pécoul, MD, director of MSF's Campaign for Access to Essential Medicines and one of the authors of the paper. "This project proves that with an organized system of procurement, prices can be reduced down dramatically and people with this form of TB will no longer be condemned to death."
The paper shows that if countries continue their spending trend on MDR-TB drugs as they did between 1998-2000 they could save as much as 93.6%. Nicaragua for example currently spends 14.9% of their TB control budget on second line drugs; these discounted prices would bring this down to 2.7%.
- "Responding to Market Failures in Tuberculosis Control" is available at www.sciencemag.org. Please note that a paid subscription to the online journal is required to read this article.