In August 2023, Johnson & Johnson (J&J) reduced the price of the lifesaving tuberculosis (TB) medicine, Bedaquiline, from US$272 to $130 per treatment course of six months for many low- and middle-income countries (LMICs). This price reduction was the result of a competitive tender by the Stop TB Partnership’s Global Drug Facility (GDF), an international pooled procurement mechanism for procurement of TB health products, and represents a watershed moment in the decade-long struggle for expanding access to Bedaquiline.
The high prices J&J charged in the decade prior to the August 2023 price reduction were entirely unjustified, especially as the development of Bedaquiline was funded predominantly through public money: the US government’s investments exceeded J&J’s by up to five times. Had J&J offered a significantly lower price closer to $130 when Bedaquiline was launched, hundreds of thousands more people with drug-resistant TB (DR-TB) would have had an opportunity to access this revolutionary medicine. However, the story of Bedaquiline played out very differently and it is worth revisiting it from the start for the lessons it holds for access to lifesaving medicines.