To: John Fagan
11 July 2019
We, the undersigned organisations, are writing to you regarding the affordability and availability of delamanid (DLM) in South Africa to patients with Rifampicin-resistant TB (RR-TB).
The national TB epidemic is among the most severe in the world. There were more than 500 new TB cases per 100 000 people and 25 per 100 000 population
Given the historic neglect in developing new TB tools, DLM is one of the few effective RR-TB drugs that can help curb the RR-TB epidemic in South Africa. However, the benefits of DLM will only be realised if it is affordable. The current price of $1,700 (R24000) for a 6 months treatment course is unreasonably high for the government to procure.
It is estimated that at least 7,700 people with RR-TB in South Africa could benefit every year from the scale-up of DLM nationally
Now that the drug has been successfully registered in the country, it is time to secure a fair price that allows for rapid scale-up. The National Department of Health has planned to procure 6,000 treatment courses for the period October 2019-September 2021 at $283 per month.
Given that there is no generic treatment currently available, and with the current patent set to expire in 20322, we believe Mylan should lower its price of DLM in order to ensure as many people with RR-TB who need it will have access to this lifesaving drug as quickly as possible.
We, therefore, request urgent reconsideration of the $1,700/six-month course price currently set for demand. Thus further improving access to the drug and allowing the highest number of lives to be saved.