TAG statement on the high price of Cepheid’s Xpert test for COVID-19

New York, March 27, 2020 — Treatment Action Group (TAG) calls for Cepheid to immediately lower to US$ 5 the developing country price of its rapid, cartridge-based test for detecting SARS-CoV-2, the virus that causes COVID-19. The U.S. Food and Drug Administration (FDA) granted Cepheid’s Xpert Xpress SARS-CoV-2 cartridge emergency use authorization on Saturday. Cepheid is marketing the test at the price of $20 for 145 eligible developing countries.[1] This is double the price of other tests—such as Xpert MTB/RIF—run on the same GeneXpert system, six times what it costs to make,[2] and well out of the reach of low- and middle-income countries, where scaling up testing could have a significant impact on stemming the tide of the pandemic, and lowering its death toll.

“By pricing its COVID-19 test at $20 for developing countries—twice the current price of the same cartridge when used to diagnose TB—Cepheid gives the appearance of profiteering at a time when the most widespread possible use of the test could help to slow the spread of the pandemic and reduce the number of deaths in these countries,” said Mark Harrington, Executive Director of Treatment Action Group.

Cepheid’s COVID-19 test, Xpert Xpress SARS-CoV-2, is a closed cartridge that runs on the same automated GeneXpert system as Cepheid’s tests for TB, HIV, HCV, and other diseases. Approximately 11,000 GeneXpert instruments with close to 50,000 testing modules are already in place in decentralized health facilities throughout low- and middle-income countries.[3] Ramping up production of Cepheid’s COVID-19 test and lowering its price to $5 would enable these countries to rapidly scale up testing at health facilities that are close to the point of care, and would help to meet the growing need for COVID-19 testing as the number of infections rise in these countries.

“Just as the COVID-19 pandemic has begun to intensify globally, Cepheid priced its test in a way that will limit its use for low- and middle-income countries,” said David Branigan, TB Project Officer at Treatment Action Group. “This demonstrates the company’s continued practice of prioritizing profit over public health and over maximizing benefit to human lives, as it has done throughout the past decade with its tests for TB, HIV, and HCV.”

In 2018, a Médecins Sans Frontières-commissioned cost-of-goods analysis found that Cepheid’s cost of manufacturing each Xpert test could be as low as $3, and that the same manufacturing efficiencies apply across Cepheid’s menu of Xpert tests for TB, HIV, HCV, and other diseases, which are priced from $10 to $20 for eligible developing countries.[4] Public funding has supported not only procurement and implementation of these tests globally, but development of the GeneXpert technology itself.[5] The public has been paying twice for Xpert tests while Danaher, the company that acquired Cepheid in 2016, has enjoyed record profits to the tune of $3 billion in 2019.[6]

Cepheid has added Xpert Xpress SARS-CoV-2 to a long list of its tests with high prices that limit access to essential testing. Outraged by this decade-long disregard for the lives and well-being of affected communities, Treatment Action Group and its allies formed the “Time for $5” campaign to rally global support to demand that Cepheid lower the price of all Xpert tests to $5. With the onset of COVID-19, this demand is as important as ever. It’s time for Cepheid to lower the price of all Xpert tests to $5, and to ramp up production and distribution of its COVID-19 test to support widespread testing in low- and middle-income countries.

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[1] Foundation for Innovative New Diagnostics (FIND) [Internet]. GeneXpert Negotiated Prices. (cited 2020 March 26). https://www.finddx.org/pricing/genexpert/.

[2] Cambridge Consultants/Médecins Sans Frontières. Cost of Goods and Manufacturing Analysis of GeneXpert Cartridges. 2019 March. Available from: https://msfaccess.org/sites/default/files/2019-12/2018%20COGS%20analysis%20of%20Xpert%20MTB_RIF%20Ultra%20cartridges.pdf.

[3] Technical Officer (Stop TB Partnership Global Drug Facility, Geneva, Switzerland). Personal communication with: David Branigan (Treatment Action Group, New York, NY). 2019 Oct 8.

[4] Cambridge Consultants/Médecins Sans Frontières. Cost of Goods and Manufacturing Analysis of GeneXpert Cartridges.

[5] World Health Organization. Global Investments in Tuberculosis Research and Development: past, present and future. A policy paper prepared for the first WHO global ministerial conference on ending tuberculosis in the sustainable development era: a multisectoral response. Geneva: World Health Organization; 2017. Available from: https://apps.who.int/iris/bitstream/handle/10665/259412/9789241513326-eng.pdf;jsessionid=1CFF87486B75690AB1FC3BFE2978CBFF?sequence=1.

[6] Morningstar [Internet]. Danaher Corp Financials. 2020 March 5 (cited 2020 March 6). https://www.morningstar.com/stocks/xnys/dhr/financials.

About TAG: Treatment Action Group (TAG) is an independent, activist and community-based research and policy think tank fighting for better treatment, prevention, a vaccine, and a cure for HIV, tuberculosis, and hepatitis C virus. TAG works to ensure that all people with HIV, TB, and HCV receive lifesaving treatment, care, and information. We are science-based treatment activists working to expand and accelerate vital research and effective community engagement with research and policy institutions.

About the Time for $5 Campaign: The “Time for $5” campaign is a global civil society movement calling on the diagnostics company Cepheid to reduce the prices of Xpert rapid molecular tests for eligible developing countries from $10-$20 to $5, inclusive of the cost of service and maintenance. These include tests for TB, HIV, hepatitis B & C, HPV, STIs, and now COVID-19. This $5 ask is underpinned by a cost-of-goods analysis that found the cost of manufacturing each test to be approximately $3.

Source: Treatment Action Group