Tuberculosis (TB)

The Green Light Committee (GLC) Initiative

What second-line anti-TB drugs are available for programmes approved by the Committee, and other questions related to second-line anti-TB drugs?

Major price reductions in second-line anti-TB drugs are achieved for GLC-approved programmes through negotiations with pharmaceutical companies and pooled procurement of drugs. The International Dispensary Association (IDA), based in the Netherlands, is the drug procurement agent for GLC-approved programmes on behalf of the GDF and the GLC. The IDA, which was selected through a tender process, continuously negotiates the best possible prices for second-line anti-TB drugs.

The second-line anti-TB drugs that are available for GLC-approved programmes at negotiated prices are:

  • kanamycin, powder for injection – 1 gram vial
  • capreomycin, powder for injection – 1 gram vial
  • cycloserin, 250 mg capsule
  • ethionamide, 250 mg tablet
  • protionamide, 250 mg tablet
  • levofloxacin, 250 and 500 mg tablet
  • ofloxacin, 200 mg tablet
  • PASER, 4 gram granule sachet.

The IDA adds a 7% procurement agent fee to the drug prices to cover its operational costs. This fee is included in the prices quoted on the GDF web site and in IDA quotations to GLC-approved programmes. IDA quotations are valid for 30 days only, because the availability of second-line anti-TB drugs at concessional or negotiated prices varies and prices are therefore subject to change.

For other second-line anti-TB drugs that are recommended in WHO MDR-TB treatment guidelines and are not listed above, GDF and IDA can supply quality-assured drugs at best available prices. Further details about second-line anti-TB drugs (for example, dosage, pack size, prices) can be found on the GDF web site.1

Note. Following an agreement between WHO and the drug manufacturer Eli Lilly, limited quantities of capreomycin and cycloserine are offered at concessional prices to GLC-approved programmes. The prices of these two drugs are therefore more likely to vary given the availability of these two drugs at the time of procuring an approved request.