TB Alliance Delivers: Pretomanid Price Cut by 25%, Boosting Global Access

In an important milestone in the battle against drug-resistant tuberculosis (DR-TB), the price of pretomanid—a vital part of the BPaL/M treatment regimen, has reduced by 25%, now being made available via the Global Drug Facility (GDF) at $169 per treatment regimen. That is less than $1 per day, a price threshold long championed by the international TB community. The drop not only expands availability but also represents a significant decrease from its original launch price of $364 in 2019 and $224 as of late 2024.

This cost breakthrough is largely due to TB Alliance's strategic model of collaborating with multiple quality-assured manufacturers. By facilitating healthy competition among producers, this model has made sure pretomanid becomes available quickly, affordably, and sustainably in high-burden TB countries. As a nonprofit that developed pretomanid, TB Alliance has been dedicated to both innovation and access for all.

Based on the Stop TB Partnership, the administrator of GDF, the new price for pretomanid may result in an estimated annual savings of about $37 million—funds that could be used to treat another 120,000 DR-TB patients. These savings extend beyond GDF’s procurement as national TB programs leveraging GDF’s reference prices could save another $5 million yearly by sourcing the drug directly at reduced rates.

This move also coincides with recent price drops for other key BPaL/M components, bedaquiline, linezolid, and moxifloxacin. Altogether, the complete six-month regimen is now priced at $310, representing a 47% decrease from the $588 cost in December 2022. This significant price cut increases the affordability of the World Health Organization (WHO)-endorsed BPaL/M regimen, making it more feasible for countries to scale up treatment efforts.

The new cost model is especially pertinent as around 132,000 of the 176,000 DR-TB patients diagnosed each year are candidates for BPaL/M treatment. With 110,000 courses of pretomanid ordered worldwide in 2024 alone, this is one of the quickest global adoptions of a new TB drug to date, treating more than 60% of the global DR-TB treatment market within a single year.

Lupin Limited, a significant manufacturer partner, helped facilitate this price decrease. Ramesh Swaminathan, Lupin’s Global CFO and Executive Director, reiterated their commitment: “We’re proud to reduce the cost of pretomanid for patients across the globe. We are always looking to further support equitable access to high quality TB treatments."

The advocacy community was also supportive of the announcement. Olya Klymenko from TBPeopleUkraine noted that seeing the cost of a full treatment regimen fall below $2 a day was a hard-fought victory. “This pricing milestone is a powerful reminder that effective TB treatment must also be affordable,” she said, urging governments worldwide to ensure access for all who need it.

Looking ahead, TB Alliance plans to further drive down pretomanid’s cost through additional tenders and procurement strategies. The organization is also continuing its broader mission through access initiatives like LIFT-TB, SLASH-TB, and the PeerLINC Knowledge Hub—tools designed to fast-track the global roll-out of shorter, more effective DR-TB treatment regimens.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)