The non-profit drug developer TB Alliance is in discussions with multiple drugmakers to get more of them to produce the breakthrough tuberculosis (TB) drug Pretomanid, said Mel Spigelman, President and Chief Executive of the Alliance.

“What we want to make sure is that prices of quality products are affordable and sustainable,” he said.The best way to ensure that is through competition. “When good companies compete with each other they drive prices down to this combination of affordable and sustainable price,” he told BusinessLine .

The TB Alliance’s negotiations with more companies comes against the backdrop of the 50th Union World Conference on Lung Health that got underway in Hyderabad today, amid calls from health activists for lower prices on the new TB drugs.

The first collaboration by the TB Alliance to commercialise the drug was with drug maker Mylan. And just days ago, the Alliance granted its second licence on Pretomanid to Mumbai-based Macleods Pharmaceuticals, a company with whom they already work on paediatric formulations.

The licence to Mylan becomes non-exclusive in November 2020. Speigelman clarified that other generic drug companies including Macleods are expected to get their versions of the product into the market out only after this cut-off date. Macleod has a non-exclusive licence to make Pretomanid and sell in about 140 countries, once it clears regulatory requirements. Other companies throwing their hat into the ring would also get similar similar licences, Spigelman indicated.

‘Feasible price’

Price has been a contentious issue on TB drugs, and Spigelman had told the paper years ago that TB drugs would not “mimic” the same disastrous pricing of HIV drugs.

But the recently announced price of $364 for a six-month treatment course of Pretomanid by The Global Drug Facility has been criticised by humanitarian organisation MSF (Médecins Sans Frontières) which has called for the price of the three-drug regimen to be nearly halved to $500 for a patient.

Spigelman countered, “I don’t know of any instance when within four months of a new chemical entity, there was a licence given to a generic company. That I believe may be record breaking,” he said, adding that their strategy was to get generic competition at the lowest affordable sustainable price, and to do this as quickly as possible.

“What we have to do is a fact-based objective assessment of what is a realistic price for manufacture. We need to think scientifically. I would like for the price to be a penny a pill, or a tenth-of-a-penny a pill. The question is not what price do you want to have, but what price is feasible and that is the subject of science and manufacturing abilities,” he said, adding that the present price was “unbelievably competitive”.

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