Value Propositions of New Regimens
TB Alliance sought opinions on attributes that key decision-makers want in new regimens, including safety, efficacy, drug delivery, side effect profiles, and cost.
Published in August 2009, "What Countries Want" identified the following general trends:
- Drugs that shorten treatment duration would be of high value, with a reduction of two months from the current treatment regimen for drug-sensitive disease representing a significant improvement.
- Stakeholders would be willing to pay more for faster-acting TB drugs because drugs represent a relatively small portion of current TB program costs. In addition, a shorter therapy could help increase adherence, thus increasing effectiveness and reducing the development of drug-resistant TB, which is considerably more expensive to treat.
- Recommendation of a new regimen by the World Health Organization was seen as necessary but not sufficient to drive adoption in most high-burden countries.
- Stakeholders in four of the five countries studied would require or prefer data from trials in their own countries, suggesting the need to conduct pivotal trials in multiple regions. Data on real-world effectiveness may also be necessary.
- The primary concerns about changing regimens vary widely among countries, suggesting that future efforts will be a mixture of meeting and tempering expectations.