Lupin-led price cut slashes cost of key TB drug pretomanid by 25%

This reduction supports high-burden TB countries and enhances affordability for the World Health Organization-recommended BPaLM regimen. 
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Global access to tuberculosis (TB) medicine pretomanid received a shot in the arm, as its price saw a 25 per cent drop, thanks to a third licensed partner, Mumbai-based drugmaker Lupin.

The Stop TB Partnership’s Global Drug Facility (GDF) recently announced a 25 per cent price reduction for pretomanid produced by Lupin – making the drug available through the  GDF at $169 per treatment course, down from an October 2024 price of $224. 

“GDF projects the pretomanid price reduction will save GDF clients upwards of $3 million per year,” a note from the Partnership said, adding that a lower price would further  support high-burden TB countries who relied on GDF “to set sustainable reference prices they can then use in their price negotiations when procuring large volumes of pretomanid directly from suppliers, saving National TB Programmes an additional $5 million annually.”

The Partnership pointed out that the pretomanid price reduction followed price reductions by GDF for bedaquiline (B), linezolid (L), and moxifloxacin (M) that – together with pretomanid (Pa) – comprise BPaLM, the preferred DR-TB (drug-resistant TB) regimen recommended by the World Health Organization (WHO). 

“All combined, these price reductions result in a new, lowest price of $310 per 6-month BPaLM treatment course, a price reduction of 47 percent from the December 2022 price of $588 (when WHO first recommended BPaLM ),” it said.

TB Alliance, the nonprofit organization that developed pretomanid and partnered with multiple manufacturers to improve access, said, pretomanid’ is available through GDF at $169 per treatment course — “less than $1 per day, a key pricing benchmark identified by the global TB advocacy community.”

This latest price drop—down from $364 upon pretomanid’s initial approval in 2019, reflected ongoing efforts by TB Alliance and its partners to broaden access and improve affordability through a multi-manufacturer approach to access, it said. 

Dr Mel Spigelman, President and Chief Executive Officer of TB Alliance, said, “By enabling multiple high-quality producers to supply this medicine, we’re fostering a healthy and sustainable market to deliver on our mandate that the life-saving medicines we develop will be adopted, available, and affordable to all those in need.”

The current GDF price reduction, led by Lupin Limited, represents a crucial step in delivering affordable medicine, the Alliance said, adding: “Procurement through GDF will save an estimated $37 million annually according to The Stop TB Partnership, the organization responsible for managing GDF, allowing for the treatment of an additional 120,000 people with DR-TB. “

The cost of a BPaL/M treatment course has dropped to $310—less than $2 per day, the Alliance said, of the six-month course. “In 2024 alone, approximately 110,000 courses of pretomanid were ordered across the world—enough to treat more than 60 percent of the global market for DR-TB treatment, perhaps the fastest ever scale up for a new TB medicine in modern times,” it added.

Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said, the remarkable feat” could not have come at a better time “as future TB funding hangs in the balance”.

“We want everyone to be aware of this price of $310 per 6-month BPaLM – we know that there are countries that pay much more for these treatment regimens”, she added.

“The rapid decline in DR-TB regimen prices is unprecedented given the low-volume, fragmented nature of this market. This kind of success can only be achieved with efforts by and collaboration across numerous stakeholders, including donors, governments, regulators, implementers, and a committed group of medicine suppliers”, said Dr Brenda Waning, Chief of the Global Drug Facility.

Published on April 25, 2025