Activists demand $1 a day access to bedaquiline for MDR TB

On 24 October 2018, activists interrupted the opening ceremony of the 49th Union World Conference on Lung Health in The Hague, to call on US pharmaceutical corporation Johnson & Johnson (J&J) to cut the price of the TB drug bedaquiline in half, to ‘one dollar per day’, so that people who urgently need it can afford it.

The World Health Organization (WHO) recently recommended expanding the use of the newer oral drug bedaquiline (produced by J&J), making it a core drug for treatment of drug-resistant tuberculosis (DR-TB), while relegating to last resort those TB drugs that need to be injected and cause horrible side effects. These new treatment guidelines more than double the number of people with DR-TB for whom bedaquiline treatment is recommended. Governments must act fast to expand access to bedaquiline as a core component of safer, more effective, injection-free treatment regimens.

J&J recently reduced the price of bedaquiline to US$67 per person per month (US$400 per six-month course). However, this price falls short of making the drug affordable in countries that are hardest hit by DR-TB, especially given that bedaquiline is just one of up to seven medicines that are necessary to compose a treatment regimen for DR-TB, and considering many people will need to take bedaquiline for longer than six months.

At $67 per month, bedaquiline is more than double the price of linezolid ($29–42 per month) and up to 22 times the price of levofloxacin or moxifloxacin ($3–9 per month), the two other medicines the latest WHO treatment guidelines recommend for the backbone of DR-TB treatment regimens. However, researchers from the University of Liverpool have calculated that bedaquiline could be produced and sold at a profit for $16 per month at volumes of 108,000 treatment courses per year.

Activists today demanded that J&J cut the price of bedaquiline in half, to no higher than $1 per day—$32 per person per month—double the price that researchers estimate bedaquiline could be sold for a profit. Doubling the price is intended to account for current low volumes—only 25% of the 558,000 people estimated to have developed MDR-TB in 2017 were started on treatment, and most did not receive bedaquiline. To date, only 25,000 people have received bedaquiline worldwide.

Groups pointed to the significant taxpayer money that J&J has received for the development and introduction of bedaquiline, and the need for these public investments to be reflected in the price of the drug.