Situation and Problem of Access to Bedquiline in Patients with Drug-Resistant Tuberculosis

Abstract

Tuberculosis is a public health problem in Thailand. Bedaquiline was recommended by World Health Organization (WHO) using as part of a combination therapy in adults with pulmonary multidrug-resistant tuberculosis in many countries. Resulting’s in higher efficiency, higher cure rate, lower side effects, and shorter duration were reported. But bedaquiline's high price has caused problems with access to this drug. This study aimed to analyze the situation of bedaquiline accessibility problems in Thailand. This study was qualitative research. Collecting data were conducted in-depth interviews with nine key informants. Data were analyzed by content analysis. The results showed that bedaquiline was effective, safe, short treatment times, lower side effects, and increased adherence. The pharmacopolitics issue found that the Patent Act B.E. 2522 (1979) and its amendments may affect the drug registration of generic drug companies. Drug prices affect patients' access to medicines. Negotiating a free-trade agreement between countries may make access to drugs more difficult. In conclusion, bedaquiline is appropriate for treating drug-resistant TB patients, but issues with patent systems and negotiating a free-trade agreement can affect patients' access to the drug. Therefore, the relevant authorities should carefully consider the patent application of bedaquiline and dismiss the request if found to be disqualified from receiving patent protection and encouraging competition for generic drugs that will lower the prices of bedaquiline.