Tuberculosis - Development pipeline shows signs of life

Tuberculosis is a major cause of illness and death worldwide, but despite 14.4 million prevalent cases, 9.2 million new cases and 1.7 million deaths in 2006, the small and rapidly declining burden of disease in the seven major markets has limited drug and vaccine development activities until recently.

Drug developers and research foundations are trialling several novel vaccines and therapeutic strategies for the prevention and treatment of TB. Immunization approaches used include boosting the old BCG vaccine in order to provide better, lasting protection; new vaccines to prevent adult pulmonary TB; and immunotherapeutic vaccines.

In 2007 the global TB market was worth approximately $300 million, expanding at a modest CAGR of 2.2% from 2004-2007. Given the low incidence of TB in the seven major markets, they only accounted for around 40% of total sales; the majority of revenues (60%) was achieved in the rest of world which includes the majority of the high burden countries.

The most significant commercial opportunity exists in second line therapy, since the drugs currently used in this setting suffer from greater toxicity and less efficacy compared to first-line agents. Drugs that reduce the duration of therapy and are active against drug resistant TB have a strong chance of gaining significant commercial success.

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