TB drug initiative aimed at public/private alliance
TB drug initiative aimed at public/private alliance
Rockefeller Foundation to spearhead partnership
The Rockefeller Foundation will host a conference in South Africa next month to lay the foundation for a public/private partnership aimed at developing new TB drugs. "The foundation now believes it is time to push ahead," says Ariel Pablos-Mendez, MD, MPH, the scientific adviser to the New York City-based philanthropy. "We believe that with public/private partnerships, we can get industry engaged and that we can play a role here."
"This is very exciting," says Ann Ginsberg, MD, PhD, program officer for TB, Leprosy, and Other Mycobacterial Diseases at the National Institutes of Health in Bethesda, MD. "We’re going to work together to see if we can provide a focus for new drug development." The strategy could entail an arrangement similar to the new Medicines for Malaria campaign, notes Ginsberg. The malaria campaign, which also is supported by the Rockefeller Foundation and which was announced this past November, has set as its goal the production of a new anti-malarial drug every five years at a cost of $150 million per drug.
One new analysis that insiders say probably will be presented at next month’s conference is a fresh look at the market for TB drugs. If the analysis is correct — and there’s still some fine-tuning to be done, analysts emphasize — annual global expenditures spent on patient care for TB total a breathtaking $4 billion. If those figures pan out, the pharmaceutical industry may have a much better reason to jump into TB drug development than previously supposed.
"The World Health Organization has always portrayed TB as a charity disease, but that hasn’t been based on an analysis of expenditures," says Carol A. Nacy, PhD, director of the Sequella Global TB Foundation and the designated representative for the Gates Foundation at the Rocke feller conference. "It turns out actually to be a very big pie, and it’s definitely worth going after."
The exact figure is still up in the air, but the order of magnitude — that is, billions of dollars spent treating TB every year — is certainly correct, says Joshua Salomon, the economist at Harvard University’s Center for Population Studies who performed the analysis. The basis for the estimate was drawn from a published study that estimates the cost of treating TB in the United States. Solomon took figures from that study, multiplied the per-case cost by the estimated global caseload, and adjusted for variations in costs of labor and other so-called "nontraded goods."
"It’s a bigger number than I expected," he adds. "It was so big that afterwards, I went back and thought about my assumptions." The $4 billion figure doesn’t include the costs of running national TB programs, nor of program-associated costs such as providing directly observed therapy.
"We want people to know about this figure," says Nacy. "Of course, one drug can’t capture that entire sum. But what this says is that a new TB drug could net $500 million a year if, for example, it could reduce hospitalization costs by 50%."
That number, $500 million, is traditionally cited by the pharmaceutical industry as the cost of developing a new drug and is often mentioned as one of the chief obstacles to drug development for diseases such as TB, HIV, and malaria. (See related story, p. 4.)
Is malaria program a good model?
The new Medicines for Malaria Venture (MMV), which kicked off last November, has proven a source of inspiration — and perhaps a model — for what will happen at next month’s TB conference. "Everyone has so much hope for the malaria venture," says Diana Chang Blanc, a technical officer for the World Health Organi zation’s vaccines and biologicals division. Last year, she performed an analysis that sought to get at why drug companies were so reluctant to work on new TB drugs. (See related story, p. 4.)
"For one thing, it’s an attempt to rebuild trust between the public health sector and private industry," says Blanc. "It sounds elementary, but so much mistrust has built up."
Co-sponsors for MMV include the powerful International Federation of Pharmaceutical Manufacturers Associations, the World Bank, the WHO, and the Rockefeller Foundation. MMV’s short-term goal is mainly to raise money: $15 million a year by the end of 2001, and $30 million a year for successive years. The money will be used to finance a portfolio of research projects, which should begin to result in the creation of new malaria drugs at the rate of one every five years starting by 2010.
That means each drug will cost about $150 million to bring to market — far less than the $500 million figure typically cited. Key to the arrangement is the donation of in-kind goods on the part of the pharmaceutical industry, including access to chemical libraries and high-volume screening procedures.
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