By Sharon Atieno
The price of pretomanid, the newest tuberculosis (TB) medicine, dropped to less than a dollar per day in April.
The drug is now available through the Global Drug Facility (GDF) for US$169 per treatment course, down from US$ 224 in October 2024. The initial cost during its approval in 2019 was US$364.
The price cut follows the introduction of a new formulation by Lupin (based in India), the third of five manufacturers licensed by the non-profit drug developer TB Alliance to produce pretomanid. The five manufacturers compete against each other, lowering the price of their formulations while also ensuring that key markets are served.
“This progress demonstrates how thoughtful collaboration and planning can translate into real-world impact,” said Dr. Mel Spigelman, President and CEO of TB Alliance.
“By enabling multiple high-quality producers to supply this medicine, we’re fostering a healthy and sustainable market to deliver on our mandate that the life-saving medicines we develop will be adopted, available, and affordable to all those in need. We’re grateful to partners such as Lupin and GDF for their shared commitment to supplying the market with life-saving TB medicines and stand committed to working with all our manufacturing partners to ensure equitable and affordable access.”
According to The Stop TB Partnership, the organization responsible for managing GDF, procurement through the facility will save an estimated $37 million annually, allowing for the treatment of an additional 120,000 people with drug-resistant TB (DR-TB).
The burden of DR-TB remains significant globally, with an estimated 450 000 reporting multi-drug resistant (MDR)and rifampicin-resistant (RR) TB in 2021. Specifically, MDR and RR TB caused an estimated 150,000 deaths globally in 2023.
Pretomanid is part of the six-month BPaL/M treatment recommended by the World Health Organization (WHO) to treat most forms of DR-TB. The treatment consists of bedaquiline (B), pretomanid (Pa), and linezolid (L), with or without moxifloxacin (M).
Together with recent price reductions for the other regimen components, the cost of a full BPaL/M treatment course has dropped to a new low of $310—less than $2 per day, and a 47% reduction from its December 2022 price.
In 2024 alone, approximately 110,000 courses of pretomanid were ordered across the world—enough to treat more than 60% of the global market for DR-TB treatment, perhaps the fastest ever scale up for a new TB medicine in modern times, notes TB Alliance.
“Lupin is proud to collaborate with TB Alliance and the Global Drug Facility to make pretomanid, an essential medicine in the fight against multidrug-resistant TB, more accessible and affordable for TB patients across the globe,” said Ramesh Swaminathan, Global CFO, Executive Director, Head of API Plus SBU at Lupin.
“The recent price reduction reflects our strong and deep-rooted commitment to delivering high-quality and affordable medicines to TB patients worldwide. Through this partnership, we reaffirm our dedication to patient-centric innovation and equitable access, ensuring that countries burdened by TB have the necessary treatment options they need to save lives and strengthen public health systems.”
With additional planned future tenders, TB Alliance expects additional price reductions for pretomanid in the future. Beyond pricing strategies, TB Alliance continues to develop and execute innovative market access initiatives like LIFT-TB, SLASH-TB, and the PeerLINC Knowledge Hub to speed the global uptake, procurement, and implementation of shortened DR-TB treatments for all who need them around the world.
