It has been heralded as an important step in ending the threat of tuberculosis in the United States, and one with ramifications for countries with higher incidence of the disease: a new drug to treat TB infection before it causes illness, treat it more quickly than current regimens. With standard treatment consisting of daily pills for six to nine months, findings from a Centers for Disease Control and Prevention funded trial that the addition of the drug rifapentine could shorten treatment to 12 once-weekly doses bettered the odds that more patients with latent tuberculosis could complete treatment that would rid them of TB bacteria.
In addition, further government-supported research showed that replacing a current drug with rifapentine (the brand name is Priftin) in the last four months of treating sick tuberculosis patients would ease the completion of treatment with a weekly rather than daily pill.
These advances at a time of increasing budget challenges to U.S. tuberculosis programs were heartening, except for one problem, according to a letter from advocates and physicians to Sanofi, the company that makes the drug: “the same taxpayers who funded research advances have not been able to access the drug due to its price.”
The letter is signed by 13 organizations and agencies involved in tuberculosis treatment and prevention, including Treatment Action Group, the American Medical Association, and the American Thoracic Society, as well as 21 physicians, program managers and researchers, including two members of the Scientific Advisory Committee for the Center for Global Health Policy, which produces this blog.
The letter points support the drug maker has received from the Centers for Disease Control and Prevention’s Tuberculosis Trials Consortium, and the National Institutes of Health, but says the advances in treatment that the drug could bring will go unrealized if public tuberculosis care treatment and prevention programs can’t afford to purchase it.
The drug’s cost of $51.20 for a box of 32 tablets adds up to a cost of $221 for a course of treating active tuberculosis, and $115.20 for the drug alone, in a 12 week course of treatment for infection, or latent TB, the letter says. The signers are asking Sanofi to provide the drug to public TB care providers at a cost of $35 a box. In addition, the letter points to the results of a study through the Centers for Disease Control and Prevention’s Tuberculosis Trials Consortium showing that rifapentine could shorten treatment of active TB, but added the next stage of research necessary to put the drug to that use has been endangered by sequestration and other budget cuts. The letter asks Sanofi to “match the public sector’s historic and future contributions to the development of a private sector drug,” by contributing $2 million to the TBTC for continued work to develop the drug.
Sanofi’s media office did not return calls for a comment, but sent this statement today:
“Sanofi has maintained a long-standing commitment to providing access of Priftin to patients in need of TB treatment. As part of this commitment, Sanofi continually evaluates and modifies its access programs, including its patient assistance services and the pricing structures offered to public health systems. For those patients who are unable to access Priftin, Sanofi offers Patient Assistance Connection – The Sanofi Foundation for North America that makes it possible to provide free prescription drugs to patients who do not have insurance coverage and who meet program eligibility requirements. For more information on the program, call 1-888-VISITSPC.”
Erica Lessem, Assistant Director of Treatment Action Group’s TB/HIV Project, in turn, responded to the statement.
“It’s great that they’re willing to help patients on an individual basis, but this is a systemic issue,” she said. “The signatories to the letter will wait for a formal response from Sanofi that meaningfully addresses the concerns that were raised in the letter.”