Cracking the Cost Code: Why Transparency in TB is a Matter of Life and Death

2 June 2025

In Nukus, Uzbekistan, 34-year-old surgical nurse Dilaram was devastated when she was diagnosed with drug-resistant tuberculosis (DR-TB).

But instead of facing the standard treatment, including nearly 15,000 pills to be taken over two years and painful injections causing severe side effects, she could enrol in TB-PRACTECAL, the MSF-led clinical trial testing an all-oral, six-month regimen for DR-TB.

After completing treatment with virtually no side effects, she returned to work and to caring for her two young daughters. This trial transformed her TB treatment journey and recovery.

This profound revolution in her treatment journey is not a coincidence.  It is a result of years of dedicated clinical research, shaped by experiences of people like her and driven by significant contributions and efforts from public and non-profit organisations working closely with people affected by TB in low-resource settings.

TB-PRACTECAL, a landmark clinical trial led by Médecins Sans Frontières (MSF), not only identified an all-oral, six-month regimen for DR-TB,  but it is also the first clinical trial for which the detailed costs, €33.9 million, were published in the journal PLOS Global Public Health. 

This stands in stark contrast to the opaque norms of pharmaceutical research and development (R&D), where there is no transparency about what it costs to develop new medicines although high drug prices are often justified based on high R&D costs.

This moment is more than a medical milestone. It marks a critical step toward accountability in medical innovation and demonstrates  to all stakeholders that transparency in R&D is both possible and essential.

When costs are hidden, governments—and organisations like MSF that purchase medical products—lose the leverage to negotiate affordable prices. We therefore ask: what does the pharmaceutical industry have to hide? If their costs are truly high, why not publish them? They refuse because transparency would undermine their ability to charge whatever prices they like, even for lifesaving TB medicines.

Read the full Inside View at Health Policy Watch.

 

Source: Health Policy Watch