The global strategy for fighting the spread and impact of TB is heavily supported by the Global Fund through multiple grants to national TB and HIV programs. This can represent up to three quarters of funding for programs in high-burden countries. A large proportion of those funds are used to buy medicine and other commodities.
In a working paper Examining the trends in costs of medicines for drug-susceptible and drug-resistant tuberculosis from 2010 – 2013; an analysis of Global Fund PQR data, published here, Aidspan examines cost trends for selected TB medications purchased with Global Fund support.
The analysis compares both costs for first- and second-line treatments over time and costs paid by the 22 high-burden countries (HBC) compared to the low burden countries (LBC).
Study findings show the median cost of all first-line TB medications was significantly lower in HBC compared to LBC with pediatric formulations about half the cost of adult medicines. There was no similar variation in costs of second-line treatments between high- and low- burden countries. Unit costs of second-line treatments were up to 100 times higher than those of first-line formulations. A rising trend was observed for first-line treatments over the four years; second-line treatment costs, with the exception of capreomycin, reduced over time.
The slow declining trends in the costs of second-line treatments and first-line treatments in LBC may be attributed to the role of the Global Drug Facility (GDF) in obtaining competitive prices through pooled procurement. Conversely, the costs of first-line treatments in HBC show characteristics of a mature market. Some of the differences in costs for pediatric and adult first-line drugs appear to coincide with the disbursement of grants by UNITAID to subsidize the cost of pediatric anti-TB drugs.
This analysis illustrates important differences in costs of anti-TB medications and highlights potential areas of intervention for initiatives aimed at accelerating progress towards achieving global TB targets, through increasing access to affordable anti-TB medications.