title: Access to new medications for the treatment of drug-resistant tuberculosis: patient, provider and community perspectives.
abstract: Multidrug-resistant tuberculosis (MDR-TB) is on the rise, and is difficult to treat. The approval of two new drugs, bedaquiline and delamanid, and growing evidence for the use of linezolid, offer renewed hope for addressing MDR-TB. However, access to these medicines remains a significant challenge. These drugs have not been registered for TB in most settings; barriers to preapproval access persist; and high pricing and intellectual property restrictions limit access. Many unanswered research questions about optimal use of these drugs also limit access, particularly for vulnerable populations. This review outlines challenges in accessing drugs encountered from the perspective of clinicians, patients and affected communities, and offers potential solutions.
authors: Treatment Action Group, New York, NY, USA. Electronic address: erica.lessem@treatmentactiongroup.org.
authors: Erica
authors: E
authors: Lessem
authors: Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
authors: Helen
authors: H
authors: Cox
authors: Treatment Action Group, New York, NY, USA.
authors: Colleen
authors: C
authors: Daniels
authors: TB Research Unit, Case Western Reserve University, Cleveland, OH, USA.
authors: Jennifer
authors: J
authors: Furin
authors: Treatment Action Group, New York, NY, USA.
authors: Lindsay
authors: L
authors: McKenna
authors: Department of Global Health and Social Medicine, Harvard Medical School; Partners In Health; Division of Global Health Equity, Brigham & Women's Hospital, Boston, MA, USA.
authors: Carole D
authors: CD
authors: Mitnick
authors: TB Proof, Cape Town, South Africa.
authors: Thato
authors: T
authors: Mosidi
authors: Olive View-UCLA Medical Center Inpatient Tuberculosis Unit, Sylmar, CA, USA.
authors: Caitlin
authors: C
authors: Reed
authors: University of Texas Health Science Center, Tyler, and Heartland National TB Center, San Antonio, TX, USA.
authors: Barbara
authors: B
authors: Seaworth
authors: City University of New York Graduate Center, NY, USA.
authors: Jonathan
authors: J
authors: Stillo
authors: Independent activist, Cape Town, South Africa.
authors: Phumeza
authors: P
authors: Tisile
authors: TB Proof, Cape Town, South Africa.
authors: Dalene
authors: D
authors: von Delft
mesh_terms: D000995:Antitubercular Agents / Q000191:economics / Q000627:therapeutic use*; D057176:Compassionate Use Trials; D064687:Diarylquinolines / Q000627:therapeutic use; D006297:Health Services Accessibility; D006801:Humans; D000069349:Linezolid / Q000627:therapeutic use; D009593:Nitroimidazoles / Q000627:therapeutic use; D010080:Oxazoles / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D035862:Vulnerable Populations
chemical_list: D000995:Antitubercular Agents; D064687:Diarylquinolines; D009593:Nitroimidazoles; C516022:OPC-67683; D010080:Oxazoles; C493870:bedaquiline; D000069349:Linezolid
keywords: Access; Community; Compassionate use; Drugs; Multidrug-resistant tuberculosis; Tuberculosis