October 31, 2014

Satellite Symposium: The pediatric TB drug market: progress and future direction

Market understanding: new data on the purchasing habits of 22 high-burden countriesCherise ScottDirector, Pediatric Programscherise.scott@tballiance.org

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Unmet Medical Need Not enough kids being treated – and not being treated appropriately

GoalIncrease access to correctly dosed, properly formulated, affordable, high quality pediatric TB medicines

Implementing Partner

TimelineHigh quality, child-friendly, properly dosed HRZ, HR and E products available by early 2016

Speeding Treatments to End Pediatric TB (STEP)-TBOverview

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Uptake Influenced• Global treatment

guidelines adopted

• National guidelines developed and health workers trained

• Child TB included in NSPs and Global Fund Concept Notes

• Funding committed for product and implementation

Drugs Available• Correct dosage &

dispersible form for HRZ, HR, and E

• Shorten gap between approval of adult products vs. pediatric products

Market Catalyzed• Market Research--How

many patients? Where? How are they currently being treated?

• Manufacturers’ commitments

• Momentum and visibility

Scope of Pediatric InitiativeThree Key Outcomes

Mid- 2013 Mid- 2016

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• To understand countries readiness to adopt new child-friendly formulations• To understand procurement processes and timelines in priority

countries including key drivers and criteria for decision-making• To obtain insight into the types and sources of funding used for

pediatric treatments• To identify potential barriers and bottlenecks to introduction and

scale up of new formulations• To gather data in order to inform targeted uptake planning

activities and specific country strategies• To landscape important stakeholders and partners in priority

countries

What we learn from the purchasing practices of countries? Purpose of Procurement Study

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• Considered the largest supplier to national TB programs of quality pediatric TB drugs• Possesses the most comprehensive data set on pediatric TB drug

procurement• Supplies products to countries through a direct procurement

service and also offers grants to countries through donor funds• 12 HBCs procure pediatric products from GDF as of 2014• Pediatrics products procured by grants and direct purchase using

donor funds

Initial Analysis

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Current Pediatric TB Market Understanding

Source: 2014 WHO Global TB ReportGDF Procurement Database

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Ind ia

Ch ina

Ph i l ipp in

es

South A

fric

a

Indonesia

Pak istan

Bang ladesh

DR of C

ongo

N iger ia

Ethio

p ia

Myanm

ar

Moza

mbiq

ue

Kenya

UR of T

anzan ia

Afghan ist

an

Uganda

Cambod ia

Viet N

am

Z imbabwe

Russia

n Federa

ti on

Brazi l

Thai land

172,

740

47,6

91

35,6

45

35,5

56

35,3

28

35,092 31,0

28

29,8

02

28,0

90

25,7

61

13,9

16

13,6

84

12,1

34

9,15

6

9,15

4

8,63

8

8,29

2

8,15

3

6,77

3

4,22

5

3,59

6

3,47

5

mEDIAN pEDIATRIC tb new Cases Per year IN 22 hbcSModeling the pediatric TB Burden in 22 HBCsMarket Quantification

Current Global Drug Facility (GDF) Clients

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• Evidence that procured based on 2010 Rapid Advice

• Policy and Implementation of the 2010 Rapid Advice

What we knowHBCs supplied Peds Rx by the GDF

Afghanistan Bangladesh

Cambodia Kenya

Myanmar Nigeria

Pakistan

Afghanistan Bangladesh

Cambodia Congo (DR)

Kenya Mozambique

Myanmar Nigeria

Pakistan Tanzania (UR)

Uganda Viet Nam

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What we knowHBCs NOT supplied Peds Rx by the GDF

Brazil Policy change and adoption to 2010 Rapid Advice; procure from PAHO

China Policy unknown; NTP has shown interest; Adult products used for children

Ethiopia Policy change and adoption of 2010 Rapid Advice; procurement unknown

India Modified policy; some indication that changing to daily dosing; extent of use of pediatric FDCs unclear

Indonesia Policy change and adoption of 2010 Rapid Advice; local procurement of pediatric FDCs (NOT PQ’d)

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What we knowHBCs NOT supplied Peds Rx by the GDF

Philippines Policy change and adoption of 2010 Rapid Advice; local procurement; adult products and syrups are used

Russian Federation Policy unknown; adult products used

South Africa Policy change and adoption of 2010 Rapid Advice; local procurement

ThailandPolicy change and incomplete implementation of 2010 Rapid Advice; create on solutions using adult products from local manufacturers

Zimbabwe Policy change and adoption of 2010 Rapid Advice; unknown procurement

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• Underscores the need for strategy to access the markets outside of the GDF to create a viable market• Feeds into larger efforts to understand all the aspects of the market

especially in specific countries• Procurement within the private sector needs to be further

ascertained in these markets• Country adoption of formulations can not be taken for granted• Understanding where, when and what regarding country

procurement of products to treat children shows where to target product launch/introduction efforts• The timeline and location can be charted for introduction of the

new pediatric formulations

Using the data to inform product introduction and uptakeConclusions/Next Steps

Thank you!

For more information on childhood TB go to: tballiance.org/children

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