2019 Presentation TB medicine costs for rifampin …...RESULTS • MDR-TB medications cost per...
10
TB MEDICINE COSTS FOR RIFAMPIN- RESISTANT TUBERCULOSIS TREATED WITH A SHORTER REGIMEN Jan Komrska, Senior Pharmacist, Vital Strategies
Transcript of 2019 Presentation TB medicine costs for rifampin …...RESULTS • MDR-TB medications cost per...
TB MEDICINE COSTS FOR RIFAMPIN-RESISTANT TUBERCULOSIS TREATED
WITH A SHORTER REGIMEN Jan Komrska, Senior Pharmacist, Vital Strategies
OUTLINE• Background
• Methodology
• Results
• Conclusions
BACKGROUND• Procurement of medicines for STREAM clinical trial, 2011–2019
• Regimens:
o Isoniazid – Kanamycin – Prothionamide – Clofazimine – Ethambutol – Moxifloxacin –Pyrazinamide
o Isoniazid – Amikacin – Prothionamide – Clofazimine – Ethambutol – Levofloxacin –Pyrazinamide
• TB medicine Sources: Global Drug Facility/IDA Foundation and Appointed Agent or Manufacturers directly
• Medication costs accounted for 6% (South Africa) to 33% (Ethiopia) of treatment costs
METHODOLOGY • Prices from 50 purchase orders collected
• Average prices calculated per year
• Cost of medication calculated per patient >50 kg
• Logistics fees were excluded (e.g. shipping, customs, duties)
RESULTS• MDR-TB medications cost per patient decreased from 1,900 USD
(2011) to 620 USD (2019) – 67% decrease
• Three medicines – clofazimine, kanamycin/amikacin, moxifloxacin/levofloxacin – accounted for 94% (2011) to 82%(2019) of medication costs
RESULTS
-
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2011 2012 2013 2014 2015 2016 2017 2018 2019
Cos
t (U
SD)
Year
Evolution of MDR-TB Medication Costs per Patient (>50 kg)
Moxifloxacin Levofloxacin Clofazimine Kanamycin Amikacin Pyrazinamid Prothionamid Ethambutol Isoniazid
RESULTS
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2012 2013 2014 2015 2016 2017 2018 2019
Evolution of MDR TB Medication Costs per Patient (>50 kg)
Moxifloxacin Levofloxacin Clofazimine Kanamycin Amikacin Pyrazinamid Prothionamid Ethambutol Isoniazid
RESULTS
00.20.40.60.8
11.2
GDF ManufacturerCos
t per
Tab
let (
USD
)
Source
Moxifloxacin*2016
0
0.01
0.02
0.03
0.04
0.05
GDF ManufacturerCos
t per
Tab
let (
USD
)
Source
Ethambutol** 2017
0
0.005
0.01
0.015
0.02
0.025
GDF ManufacturerCos
t per
Tab
let (
USD
)
Source
Isoniazid*** 2017
• Sourcing TB medicines directly from the manufacturers resulted in 60% higher costs
*400mgtablet**400mgtablet***100mgtablet
CONCLUSIONS• Increased demand for TB medicines through clear treatment
guidelines and pooled procurement results in lower prices and decreased medication costs
• Poor forecast/unexpected demand and ad-hoc procurement increases prices and results in increased medication costs
• Future savings for MDR-TB regimens could be achieved through price reductions for clofazimine
THANK YOU
This study is made possible by the generous support of the American people through the United States Agency for InternationalDevelopment (USAID) through the TREAT TB Cooperative Agreement No. GHN-A-00-08-00004. The contents are the responsibility of theauthors and do not necessarily reflect the views of USAID or the United States Government
