In July 2021, MedAccess, in partnership with CHAI and Unitaid, executed a volume guarantee agreement with Macleods Pharmaceutical Limited to catalyse access to 3HP, a short-course (3-month) tuberculosis preventive therapy (TPT) that improves completion rates over the standard of care in people living with HIV and their household contacts.
The volume guarantee agreement complements a broader set of interventions provided by the Clinton Health Access Initiative (CHAI) and Unitaid to support the commercialisation and roll-out of the 3HP product. In this transaction:
Through this partnership, Macleods has also agreed to extend its commitment to make 3HP available at $15 per patient course for 138 low- and middle-income countries.
Lives changed: Downstream patient outcomes were estimated based on the pooled risk analysis developed for the 2020 update of the WHO Latent Tuberculosis Infection Guidelines, and represent relative risk for people living with HIV when comparing 3HP to the current standard-of-care, isoniazid preventive therapy.
Money saved: Impact is estimated based on actual price reductions for 3HP over the course of the volume guarantee.
Markets shaped: We work with partners, including donors, procurers and ministries of health, to track changes in health markets where our investments are supporting access to products. We monitor for changes to policy, procurement practices and supplier movement, all of which affect markets and contribute to the long-term sustainability of impact.
3HP is a fixed dose combination therapy that combines two antibiotics for the treatment of latent tuberculosis infection – Isoniazid and Rifapentine. 3HP is a short course regimen, taken once a week for 3 months. It has been found to be as effective as Isoniazid Preventive Therapy – a longer daily 6- to 9-month treatment, but with fewer side effects, and better completion rates (as published by Churchyard et al. 2021) due to less frequent dosing and a reduced treatment duration.
TB is the world’s second leading cause of death from an infectious disease, claiming 1.5 million lives in 2020. Latent TB Infection (LTBI) occurs when someone is infected with TB-causing bacteria but is asymptomatic and non-infectious. About a quarter of the world’s population – 1.7 billion people – are estimated to have LTBI. In 2020, an estimated 10 million people went on to develop active TB. Over a lifetime, the chance of LTBI activating to TB is much higher in people living with HIV and household contacts.
3HP provides an opportunity to increase treatment uptake and improve outcomes for LTBI patients. However, demand has been largely unmet due to high prices and supply constraints. This partnership will improve supply security, secure the previously negotiated $15 price, and create a pathway for increased availability and access to the product over time.