Answer to costly pills: Stop TB Partnership's Global Drug Facility -- the platform for TB medicines amidst recent US drug storm

In contrast to the recent US cycloserine price increase, the Global Drug Facility slashed the price of cycloserine by 55% earlier this year compared to the previous year.

28 September 2015 - Geneva, Switzerland - The US market for cycloserine - a drug used to treat multi-drug resistant tuberculosis (MDR-TB) - had a 2,000 percent price increase when it was recently sold to Rodelis Therapeutics. Due to public outcry, the massive overnight price increase for this specialized tuberculosis drug was rescinded on Monday after the company that acquired the drug’s rights returned it to its previous owner.

The Chao Center at the Purdue Research Foundation, the drug’s original owner, will now price cycloserine at $1,050 for 30 capsules, double the pre-August price. Chao reported that they had no choice but to raise their original $500 price as it was unsustainable and left them with a reported $10 million loss since 2007 due to the small number of MDR-TB patients and high regulatory costs in the US. The price increase to $1,050 is still extremely expensive, especially given that cycloserine is one of at least four medicines needed in a 20-month treatment course for MDR-TB.

In contrast to the recent US cycloserine price increase, the Stop TB Partnership’s Global Drug Facility (GDF) slashed the price of cycloserine by 55% earlier this year compared to the previous year, and by 68% compared to 2010 prices. This price reduction is expected to save up to US$ 22 million annually, enabling many more people to have access to this life-saving medicine. The GDF’s current price for 30 capsules of cycloserine averages less than $6 - compared to the new price of $1,050 in the US market. Discussions are ongoing to work through process barriers that would allow the US to purchase tuberculosis medicines via the GDF.

The GDF, one of the Stop TB Partnership's teams, established in 2001 to provide tuberculosis (TB) medicines to low- and middle-income countries, is able to access much lower prices through the use of various strategies that aim to promote competition in the global MDR-TB market.

When individual countries try to purchase low-demand, specialty medicines from domestic or regional markets, they are unable to obtain consistent supplies of affordable MDR-TB medicines. The GDF, however, is able to pool demand, negotiate prices, and purchase medicines across more than 130 countries. The pooled procurement system with competitive, transparent bidding and long-term supplier agreements, along with other activities to attract new manufacturers into the market have enabled GDF to expand the supplier base, promote competition, and consistently secure low prices of quality-assured medicines.

The US cycloserine price increase comes amid another US controversy over a 5,000 percent price hike for Daraprim, a 62 year old drug that is used to treat patients with malaria and toxoplasmosis, a rare parasitic infection.

Brenda Waning, Chief of the GDF, noted "The entire world is struggling with skyrocketing drug prices. Countries who limit themselves to purchasing medicines in their own national markets will continue to struggle with high prices. The GDF has achieved success in shaping and accessing global markets that function much more efficiently than national markets - especially for low-demand, specialty medicines." She added "Mechanisms like the GDF can leverage the volume of more than 100 countries and offer lower-priced drugs through a combination of regulations and incentives that not only reward innovation, but also promote competition and prevent exorbitant pricing. This is the way forward for all countries, both rich and poor."

Today, as one of the main players in the complex global market for TB drugs, the GDF plays a crucial role in not only shaping drug and diagnostics supply, but also in reducing the price of medicines and promoting access to all those in need of these medicines -- irrespective of their country of origin. While the GDF was originally designed to serve low- and middle-income countries, the GDF will continue to address the alarming trend of medicine price increases in developed countries, as well.