TB Therapy Market Predicted to Reach $700 Million, But WTO Deal Casts Doubt on New Drug Development

November 14, 2001

NEW YORK (Reuters Health) - In a bid to promote industry interest in tuberculosis (TB) drugs, non-profit group the Global Alliance for TB Drug Development released on Thursday a report estimating that the market for drugs combating the disease will approach $700 million by 2010.

And while this report appears to provide an incentive to keep on producing existing TB medicines, a World Trade Organization (WTO) decision this week that seemingly opened the door for poor nations to skirt drug patent laws, raises questions as to whether companies will bother to develop new treatments.

TB infects approximately 8 million people each year, roughly 80% of whom live in poor countries that often cannot afford to pay the high prices of prescription medicines. Experts have noted that the last innovative medicine for treating TB was developed more than 30 years ago, and critics of the drug industry say that it has spent little time and money in recent decades pursuing newer treatments for diseases that mostly impact the developing world. Instead, they charge, the drug industry has chosen to focus on lifestyle treatments for such conditions as baldness and impotence that concern wealthier nations.

Dr. Giorgio Roscigno, director of strategic development at the Global Alliance, told Reuters Health that the group conducted an analysis of epidemiologic trends, which indicate that a TB increase is likely to mostly occur in Africa and Asia "mainly due to the co-infection with HIV."

Based on this analysis, and keeping current TB drug prices static, the Global Alliance estimates that the current $450 million global market for TB drugs will increase to roughly $670 million over the next eight years, he said.

Although this projection somewhat allays fears over a dwindling market potential for existing TB drugs--the report assumes that between $300 million and $375 million would be spent on generics currently used--it is unclear how accurate the Global Alliance's estimated market potential for new TB drugs really is.

In its report, the Global Alliance said that the potential of a new TB drug, one that reduces the treatment course from six months to less than two months, has the capacity to capture between $325 million and $400 million of the $700 million market.

But on Wednesday, members of the WTO agreed that the organization's intellectual property agreement, called TRIPS, "can and should be interpreted and implemented in a manner supportive of WTO members' right to protect public health and, in particular, to promote access to medicines for all."

Such a declaration ostensibly allows poor nations to undertake compulsory licensing measures and simply begin to manufacture on its own those patented medicines that it needs but cannot afford to buy from a drug company.

In a telephone interview with Reuters Health, Global Alliance CEO Dr. Maria Freire agreed that the market potential of TB treatments, as well as just about every other drug, in poor nations stands to be significantly impacted by compulsory licensing programs.

And while she also agreed that this could present a roadblock to promoting industry participation in TB drug development, Dr. Freire pointed to a number of factors that she believes will make the difference in enticing drug firms to join the effort.

She cited philanthropy as one. "Companies want to be seen in a good light," she said, adding that the financial support of such non-profit institutions as the Global Alliance is likely to help firms do so at an even lower cost.

Dr. Freire also pointed to the renewed interest in infectious diseases in countries such as the US. "[Infectious diseases] were not the babies of the market, but they're going to become more and more important."

"Tuberculosis [is] one of those infectious diseases that is enfranchised, it exists in New York, it exists in London, etcetera," she said. "So there is a market in the north for TB."

"And, the science in tuberculosis is interesting," she said. "Whatever we discover in the process of creating this new drug for tuberculosis will, in fact, be applicable to other diseases and infections."

As to the question of whether these things will make a difference to the drug industry, Dr. Freire remains optimistic.

"This is an experiment and I think it is going to work," she said. "I think it is going to work because, in fact, we are talking to these people. Will they be there ten years from now? I think so."