Availability, price and affordability of anti-tuberculosis drugs in Europe: a TBNET survey

Eur Respir J. 2015 Apr;45(4):1081-8. doi: 10.1183/09031936.00124614. Epub 2014 Nov 13.


Data on availability and cost of anti-tuberculosis (TB) drugs in relation to affordability at national level are scarce. We performed a cross-sectional study on availability and cost of anti-TB drugs at major TB-reference centres in 37 European countries. Costs of standardised treatment regimens used for pan-sensitive TB, multidrug-resistant (MDR) TB, pre-extensively drug-resistant (XDR) TB, and XDR-TB were compared using a purchasing power analysis. Affordability was evaluated in relation to monthly national gross domestic products per capita (GDP). At least one second-line injectable and either moxifloxacin or levofloxacin were available in all countries. Linezolid and clofazimine were available in 79% and 46% of the countries, respectively. Drug cost for XDR-TB was three-times more expensive than those for MDR-TB. The average price of treatment for pan-sensitive TB represented a maximum of 8.5% of the monthly GDP across countries, while for standard MDR-TB treatment this was <30% in only six countries and more than 100% in four countries. Treatment of XDR-TB represented more than 100% of a month's GDP in all countries where the regimen was available. High cost and limited availability of drugs for treatment of drug-resistant TB, particularly beyond resistance to first-line drugs, are a major impediment to successful TB control in Europe.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / economics*
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • Cross-Sectional Studies
  • Drug Costs / statistics & numerical data*
  • European Union
  • Extensively Drug-Resistant Tuberculosis / diagnosis
  • Extensively Drug-Resistant Tuberculosis / drug therapy
  • Extensively Drug-Resistant Tuberculosis / economics
  • Female
  • Health Care Costs
  • Health Resources*
  • Health Services Accessibility / economics
  • Humans
  • Male
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / economics*
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / economics


  • Antitubercular Agents