The new three-month treatment course, called 3HP, will initially only be provided to eligible people at risk of TB in the Oliver Tambo District in the Eastern Cape, Johannesburg and Ekurhuleni in Gauteng, eThekwini in KwaZulu-Natal, Ehlanzeni in Mpumalanga and Cape Town in the Western Cape. The phased roll-out will be scaled up to include 23 districts before the end of next year.
Professor Gavin Churchyard, founder and CEO of the non-governmental organisation the Aurum Institute, agrees. Now it’s time to achieve further price reductions for rifapentine so that the 3HP regimen becomes affordable for everyone at a price government can sustain over the long term.Dr Lindiwe Mvusi, director of the TB control and management cluster in the national department of health, agrees.
“Ensuring all people at risk of TB can access rifapentine-based TB preventive therapy will require further reducing the price of rifapentine. The expected entry of additional generic manufacturers of rifapentine should put some downward pressure on price through competition and increased supply. But governments should not leave affordability to the market alone,” Frick says.
“Rifapentine is produced by one supplier, Sanofi, in a factory in Italy. The production capacity is limited to 1.2 million annually. The lockdown affected the monthly deliveries as agreed upon in our demand plan,” she says.“Sanofi reported unacceptable levels of nitrosamine impurities in the rifapentine tablets around July last year,” says Mvusi.
Clinicians should educate patients about possible adverse effects and instruct them to stop taking their medicine and to seek medical attention when signs and symptoms of adverse events first appear.Yet, even though the roll-out of 3HP in South Africa will now start, supply from Sanofi remains constrained – which is why the initial roll-out is restricted to six districts.
Source: Healthcare Press (healthcarepress.net)
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