Price of Key Drug-Resistant TB Medicine Drops by 25 pc

The price of pretomanid, a key drug used to treat drug-resistant tuberculosis (DR-TB), has recently dropped by 25 percent to under US$1 per day — a significant development for high-burden countries facing financial strain in their health sectors.

The price cut comes as Indian pharmaceutical company Lupin enters the market, becoming the third of five manufacturers licensed by the nonprofit TB Alliance to produce pretomanid. This move is part of TB Alliance’s broader strategy to expand access and drive down costs through competitive manufacturing.

As competition increases, the price of pretomanid formulations continues to fall while the reach of treatment grows. Pretomanid is a core component of the World Health Organization-recommended BPaL/M regimen — a six-month treatment for most forms of DR-TB. The combination includes bedaquiline (B), pretomanid (Pa), and linezolid (L), with or without moxifloxacin (M).

In 2024 alone, around 110,000 courses of pretomanid were procured globally, covering more than 60 percent of the DR-TB treatment market. According to TB Alliance, this represents one of the fastest scale-ups of a new TB drug in recent history.

Despite progress, global DR-TB treatment remains inadequate. WHO estimates that of the 400,000 people with DR-TB each year, only about 40 percent receive treatment. The lower price of pretomanid, now available through the Global Drug Facility (GDF) managed by the Stop TB Partnership, aims to close this gap. GDF procurement is projected to save US$37 million annually and enable treatment for an additional 120,000 patients.

When asked how the price drop might impact countries like Bangladesh, TB Alliance’s Senior Vice President of Market Access, Sandeep Juneja, said Bangladesh ranks among WHO’s top 20 high MDR-TB burden countries, with an estimated 5,000 cases in 2023. The reduced price will allow Bangladesh’s National TB Programme to extend its reach and treat more patients within its existing budget.

“Every person with DR-TB deserves access to the best care — and this price drop, available immediately through the Global Drug Facility, is a big step toward making that happen,” Juneja said.

He added that pretomanid now costs $169 per full treatment course — less than $1 per day. The complete BPaL or BPaL/M regimen can be procured for $310 per course, or under $2 a day, hitting a long-advocated pricing target of the global TB community.

In Bangladesh, where around 80 percent of TB cases are treated in the public sector, these savings will primarily benefit the national healthcare system, allowing more patients to be treated more cost-effectively.

Moreover, shorter treatment durations with BPaL/M reduce the indirect financial burden on patients, including costs related to travel, missed work, and time away from family.