PARIS, Nov. 14 — Trying to entice major drug companies into plunging into the tuberculosis market, the new Global Alliance for TB Drug Development is to release a study on Thursday that estimates that the market will be worth $700 million a year by 2010.
But because big pharmaceutical companies prefer to concentrate research on drugs that will yield $1 billion in yearly sales, it is not clear how much incentive will be provided. The study assumes that half the $700 million would be spent on the low-profit generic drugs that are now used.
A typical TB patient takes a cocktail of three or four drugs for six months. If a company can invent a drug that cures tuberculosis in two months, the company would probably make $325 million a year with it, the alliance estimated. The study offers insight into one of the grimmest aspects of the pharmaceutical industry. Although companies spend fortunes in hunting for cures for baldness, obesity and impotence, they shy away from diseases, including TB. No new TB drug has been patented in 30 years.
A reason is that most TB cases are destitute, from poor countries who can pay little. Also, it is a bacterial disease cured by antibiotics. A company that invents an antibiotic hopes to earn billions while the patent lasts by selling it in rich countries at high prices to cure everything from surgical infections to children's sore ears. If a drug is tested and found effective against TB, pressure may grow to sell it cheaply in poor countries.
New outbreaks in London and New York and a surge of drug-resistant strains in Russia, China and the Middle East have increased manufacturers' interest, said Gwynne Oosterbaan, a spokeswoman for the group. Also, the anthrax problem is focusing attention on powerful antibiotics and their high-profit markets.
Although one-third of humanity carries the mycobacterium tuberculosis — and anyone who has ridden on a subway train has a good chance of having inhaled it — only those whose immune systems have been suppressed by AIDS, alcohol or drug addiction, cancer therapy or malnutrition are likely to develop the active disease.
What was once one of the world's great killers now has eight million new cases a year. AIDS has made the death rate soar. The alliance was created a year ago with $150 million from the Rockefeller and Gates foundations, the Wellcome Trust, other charities and governments to help overcome the reluctance to conduct research.
Ideally, said Dr. Giorgio Roscigno, a former drug executive who led the study, the alliance will invest money in promising antibiotics, and gain some ownership. Then, if a product passes the lengthy testing, which can cost $40 million or more and is usually underwritten by the pharmaceutical giants, the alliance will be able to insist that the drug be sold cheaply in poor countries while the manufacturer reaps profits in rich ones.
By the end of the year, the alliance would like to announce the names of five new compounds that it hopes to invest "a couple of million" in, said Joelle Tanguy, another spokeswoman for the group.
John Horton, who runs a unit that investigates diseases of poor countries at GlaxoSmithKline, the world's largest drug company, said drug companies now recognize that "the market for diseases such as TB deserves more attention, and the way to leverage this is through partnerships."
A spokesman for the manufacturers' lobby in Washington, Mark Grayson, said it would not comment until had seen the study.