Geneva, 17 June 2024 - In September 2023, the US corporation Danaher, which owns diagnostics maker Cepheid, announced a price reduction of the primary GeneXpert test used to diagnose tuberculosis (TB), from US$9.98 to $7.97, amid pressure from TB activists. Since then, officials from the Ministries of Health of Sierra Leone, Ghana, Ukraine, Belarus and several other low- and middle-income countries have written to Danaher, requesting that the price of the tests for extensively drug-resistant TB (XDR-TB), HIV and hepatitis—currently priced at $14.90 per test cartridge—also be lowered to no more than $7.97.
“My country has a significantly high number of people living with HIV and hepatitis, many of whom live in remote areas where point-of-care Xpert tests are a must to avoid considerable delays in receiving results from far away testing labs,” said Dr Stephen Ayisi Addo, Programme Manager of the National AIDS/STI Control Programme of Ghana. “Rapid turnaround times are particularly important to start timely treatment in case of infants, children, as well as pregnant and breastfeeding women. But the high price of your cartridges continues to be a barrier for us to scale up testing. We ask Danaher to reduce the price of the Xpert HIV, hepatitis C and B viral load test cartridges to no more than $7.97, the same price as the Xpert TB test. We can’t accept that we must pay double the price for a test that can help us to diagnose people with HIV and hepatitis.”
Doctors Without Borders/Médecins Sans Frontières (MSF) strongly supports these demands made by countries and has called on Danaher to take urgent steps to lower the prices of XDR-TB – the most severe form of TB – HIV, hepatitis and all other GeneXpert tests to $5, so that the limitedbudgets available in low- and middle-income countries for treating and controlling these diseases can be optimally used to save many more lives. MSF published a study in 2019 showing that the GeneXpert tests can be sold at $5 each by the corporations while still making significant profits.
But Danaher and Cepheid continue to charge between $15 and $20 for the same type of test used to diagnose other diseases. These prices are 200% to 400% higher than the $5 it is estimated to cost them to make one test.
“In the past few months, we have learned that the Ministries of Health from at least seven countries have written letters to Danaher, requesting immediate action to lower the prices of the GeneXpert test cartridges supplied by Cepheid,” said Stijn Deborggraeve, Diagnostics Advisor for the MSF Access Campaign. “It is extremely disappointing that none of these countries have yet received any response from Danaher, nor has there been any announcement by the corporation regarding price reductions of the GeneXpert tests for HIV, hepatitis or other diseases. We call on Danaher to listen to these countries’ demands and reduce the prices of all these lifesaving medical tests immediately. Only by listening to countries and taking the required actions will Danaher demonstrate its commitment to its stated mission to improve quality of life around the world.”
In addition to letters sent by country programmes, the Institute of Tuberculosis and Lung Disease of Poland sent Danaher a letter to reduce the excessive price of the TB tests in Poland. Also, the Americas TB Coalition, representing over 17 countries in the Latin American and Caribbean region, reiterated this demand in their letter.
The price reduction announced 9 months ago for the primary TB test to $7.97 is expected to result in annual savings of $32 million for the international procurement agency, Global Fund to Fight AIDS, Tuberculosis and Malaria, enabling it to purchase an additional 3.6 million tests every year. As a result, many more people with TB will receive timely diagnosis and treatment, and ultimately more lives will be saved. Reducing the test prices to $5 for all tests now would immensely help low- and middle-income countries, and medical humanitarian organisations such as MSF, in timely testing and treating of people affected by other diseases including XDR-TB, HIV and hepatitis.
In its September 2023 announcement, Danaher also mentioned that it would validate its actual cost of test production annually by an internationally accredited third party, and adjust its pricing accordingly, but no details on this have yet been released.