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An exhaustive new report on the size of the world market for TB drugs turns some long-held assumptions on their heads. According to a report released last month by the Global Alliance for TB Drug Development, the current market size for TB drugs is a respectable $450 million, in contrast to long-held drug-industry suppositions that its size was only about $150 million. More surprising, perhaps, is the finding that 67% of the market resides in the private sector, with fully half of that private market found in poor countries where high rates of TB are endemic.
"I suppose that was the greatest surprise for us — to find out that the private market was so big and to see how much of that private market is found in developing countries," says Giorgio Roscigno, the former drug company executive who until recently served as head of the Alliance. "When you look at some of these numbers, from a marketing standpoint it’s truly amazing." For example, private-sector sales in India alone amount to about $100 million a year, the report found.
A new class of drug that could trim length of treatment to less than two months could grab a slice of that market worth $325 million, the report concludes. Given that hypothetical new drug, rich countries like the United States could realize impressive cost savings, says Roscigno — not in drug costs, which equal just $800 of the $25,000 annual per-case treatment cost, but in associated costs for services, such as hospitalization and clinic costs.
Counting those service costs, the United States spends at least $182 million per year treating TB, says Doris Rouse, PhD, director of technology applications center at the Research Triangle Institute (RTI) in North Carolina and chairwoman of the international committee that wrote the report. "Depending on how much treatment for latent TB infection you factor into the picture, total annual costs for treating TB could be said to run as high as $447 million in this country," adds Rouse. "So you see that reducing the length of treatment by two-thirds could reduce that cost substantially."
If TB cases continue to increase at the present rate, the world market for TB drugs will reach $700 million by 2010, the report says. "What we’re talking about here isn’t a huge market," concedes Roscigno. "Also, it is a fragmented market. But its size should certainly be of interest to small and medium-size companies. By taking a partnership approach to drug development, it will also be possible to spread the costs and risks of development more evenly."
The current bitter dispute over intellectual property rights for new AIDS drugs shouldn’t dampen any enthusiasm spurred by the Global Alliance report, Roscigno and Rouse both contend. For one thing, the dispute has raised social awareness among drug makers, Roscigno says. "There’s a powerful new wind blowing," he says. "The drug industry knows this is its chance to show it’s possible to support both public health and economic health at the same time." Plus, the Global Alliance means to ensure that any new drugs in whose development it has a hand will be affordable to poor countries, he adds — and that will be the understanding up front.
The report was 18 months in the making. A committee of over 50 international TB experts donated their time and expertise to the preparation of the report, Roscigno says. RTI’s Rouse coordinated and oversaw the committee’s work.