[Ip-health] Open Letter to Cepheid on Reducing GeneXpert Cartridge and Machine Pricing

Riaz K Tayob riaz.tayob at gmail.com
Fri Apr 20 02:10:30 PDT 2012

16 April 2012

Mr. John L. Bishop
Chief Executive Officer

Dear Mr. Bishop,


We write to follow up on our previous communications in September 2011 
and November 2010 regarding the price of Cepheid’s GeneXpert MTB/RIF 
machines and cartridges. As you know, negotiations are underway between 
Cepheid and the government of South Africa as well as between Cepheid 
and UNITAID, among others, regarding these prices.

We remain deeply disappointed that despite unprecedented momentum and 
global rollout of the Xpert MTB/RIF system, prices have failed to budge 
either for the machines or for the cartridges. According to your 4th 
quarter 2011 results online, international sales rose by 89% in the last 
quarter of 2011 compared with 2010, and 72% year-on-year overall, 
reflecting the rapid uptake and considerable global interest and need 
for the Xpert system. However, we have heard that many countries that 
want to roll out the Xpert system, such as Kenya, are unable to do so 
due to the current prices.

It therefore follows that if the machines and cartridges are too 
expensive to buy and maintain, then the volumes that need to be bought 
to witness a decrease in price as stipulated by you, will never be 
reached and we fear that prices (of cartridges and machines) will not 
decrease in the near future. Needless to say, these high prices of the 
machines and the cartridges make it virtually impossible to fulfilll the 
test's potential to move very close to being a true "point of care" test 
where people can be diagnosed for tuberculosis (TB) in their communities.

In addition, we have heard concerns from Indian providers and TB 
advocates that the current arrangement with FIND which only covers the 
public and some of the non-profit sector in high-burden countries, 
excludes from any public health access to Xpert the 80% or so of Indians 
with TB symptoms who are initially screened within the private sector.

Thus we write with the following requests:

 1. To bring down the price of a) the GeneXpert MTB/RIF machines as
    quickly as possible and b) the Xpert cartridges from $17 to no more
    than $7/cartridge for South Africa, UNITAID, and other public health
    sector and multilateral donors and providers;
 2. To create a tiered-pricing system so that private sector providers
    in high burden countries such as India are able to access the Xpert
    system at prices they can afford;
 3. To provide the audited accounts of the current manufacturing costs
    of the Xpert MTB/RIF system (machines and cartridges). This audit
    was promised via the September 2011 teleconference with
    representatives of the AIDS & Rights Alliance for Southern Africa,
    Global Health Strategies, Médecins Sans Frontières, Treatment Action
    Campaign, Treatment Action Group and other organizations, and
    expected to be completed now as per further communication between
    FIND and Médecins Sans Frontières in January 2012; and
 4. To schedule a teleconference with the undersigned at your earliest
    possible convenience to discuss these matters in more detail.

Please respond to Erica Lessem aterica.lessem at treatmentactiongroup.org 
<mailto:erica.lessem at treatmentactiongroup.org> at your earliest convenience.

We remain excited about the potential of the Xpert system to 
revolutionize case finding and early appropriate treatment of 
tuberculosis in high-burdened settings as well as disappointed by 
Cepheid’s inability to date to reflect the increasing demand with 
appropriately reduced, affordable, and sustainable prices.

Yours truly,

Polly Clayden, United Kingdom

Colleen Daniels, Australia

Nathan Geffen, South Africa

Denis Godlevskiy, Russian Federation

Mark Harrington, United States

Giselle Israel, Brazil

Bactrin Killingo, Kenya

Blessina Kumar, India

Erica Lessem, United States

Khairunisa Suleiman, South Africa

Ezio Tavora dos Santos Filho, Brazil

Wim Vandevelde, Belgium

for the Global Tuberculosis Community Advisory Board (TB CAB)

South African HIV Clinicians Society

Treatment Action Campaign, South Africa

Treatment Action Group, USA


Denis Broun, UNITAID

Margaret Chan, WHO

Lucica Ditiu, Stop TB Partnership

Eric Goosby, OGAC

Gabriel Jaramillo, GFATM

The Hon. Aaron Motsoaledi, Minister of Health, South Africa

Raj Shah, USAID

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