Time for $5 Coalition statement: Cepheid’s updated GeneXpert pricing does not address country needs

May 10, 2021 — The Time for $5 Coalition, comprised of over 150 civil society organizations globally, calls out Cepheid for the company’s insufficient and self-serving GeneXpert pricing packages for low- and middle-income countries (LMICs), announced May 6, 2021.[1]  The updated GeneXpert pricing packages include bundled pricing of Cepheid’s new 10-color GeneXpert instruments in 4-module or 16-module configurations, paired with 100-500 Xpert Xpress SARS-CoV-2 tests for COVID-19 along with the option of 100-500 Xpert MTB/RIF Ultra tests for TB.

“This is just window dressing by Cepheid, promoting the company’s newest class of 10-color GeneXpert instruments while countries even cannot afford the overpriced tests to run on the machine. This is not what countries need right now as they already have the 6-color GeneXpert instruments in place, which are capable of running the Xpert Xpress SARS-CoV-2 and Xpert MTB/RIF Ultra tests. Countries need a price reduction for the tests and not only the machines,” said Stijn Deborggraeve of Médecins Sans Frontières (MSF) Access Campaign.

The Time for $5 Coalition continues to demand that Cepheid issue widespread price reductions of its test cartridges across diseases to $5, inclusive of service and maintenance,[2] which is what LMICs need to improve access to testing and more sustainably address the concurrent pandemics of COVID-19, TB, HIV, HCV, and other diseases.

“The COVID-19 crisis continues to ravage LMIC communities and health systems, especially in India. Having battled COVID-19 and struggled to get diagnosis for weeks, the fact that Cepheid’s updated pricing does not include price reductions of Xpert tests for COVID-19 and other diseases such as TB adds insult to injury and does not deserve praise. Rather, it is a call to action to hold Cepheid accountable for fair and affordable pricing of Xpert tests,” said Blessina Kumar of the Global Coalition of TB Activists.

“These pricing packages serve to expand Cepheid’s footprint and generate sales of the company’s 10-color GeneXpert instruments in LMICs and do nothing to address the urgent need to scale up affordable testing for COVID-19, TB, and other diseases, or to address the longstanding lack of affordability and unfair pricing of Xpert tests,” said David Branigan of Treatment Action Group. “This is a clear attempt by Cepheid to increase profits without meeting countries’ immediate needs for affordable test cartridges.”

The Time for $5 Coalition’s call for fair pricing of Xpert tests is based on the cost of production plus a reasonable mark-up, along with volume-based price reductions. According to an MSF-commissioned independent analysis, it costs Cepheid about $3 to $5 to manufacture each Xpert test at overall volumes of 10 million,[3] yet Cepheid charges three to six times this amount ($9.98 for TB tests and $19.80 for COVID-19 tests),[4] limiting access to these tests in LMICs. In 2021 Cepheid is set to sell about 45 million Xpert SARS-CoV-2 tests,[5] in addition to sales volumes of Xpert tests for other diseases, which is expected to further drive down Cepheid’s cost of production and further inflate their profits.

“South Africa has struggled to secure sufficient volumes of Xpert SARS-CoV-2 tests, and the high $19.80 price of these tests has taken resources away from other areas of the national health system response to COVID-19 and the concurrent pandemics of HIV and TB. Cepheid’s inclusion of just 100-500 tests for COVID-19 and TB in these packages pales in comparison to LMIC needs and is a shameful attempt to save face while profiteering from these pandemics,” said Sibongile Tshabalala of Treatment Action Campaign.

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About the Time for $5 Coalition

The Time for $5 Coalition is comprised of more than 150 civil society organizations working across countries and diseases to improve access to rapid diagnostic testing. Since 2019, the civil society Time for $5 Coalition has demanded that Cepheid lower the price of Xpert tests to $5 per test across diseases, inclusive of service and maintenance, based on the available evidence on Cepheid’s cost of production of Xpert tests.[6] In 2021, the Coalition called on Cepheid to improve access to COVID-19 tests in LMICs by lowering the price of the tests and increasing available volumes to LMICs.[2] Cepheid has continued to refuse to reduce the prices of Xpert tests for LMICs, to overcharge the global public for these essential tests, and to prioritize making profit over saving lives.

About Treatment Action Group

Treatment Action Group (TAG) is an independent, activist, and community-based research and policy think tank committed to racial, gender, and LGBTQ+ equity; social justice; and liberation, fighting to end HIV, tuberculosis (TB), and hepatitis C virus (HCV). TAG catalyzes open collective action by affected communities, scientists, and policymakers to ensure that all people living with or impacted by HIV, TB, or HCV — especially communities of color and other marginalized communities experiencing inequities — receive life-saving prevention, diagnosis, treatment, care, and information. We are science-based activists working to expand and accelerate vital research and effective community engagement with research and policy institutions for an end to the HIV, TB, and HCV pandemics.

About MSF Access Campaign

The MSF Access Campaign is an intrinsic part of Médecins Sans Frontières/Doctors Without Borders (MSF) and is rooted in the organization’s medical operation. The MSF Access Campaign advocates to bring down barriers that keep people from getting the tests, treatments and vaccines they need to stay alive and healthy. By reshaping the system, we create long-lasting pathways to improve access to medical tools that are available, affordable and adapted to the people’s needs and the places where they live.

About GCTA

The Global Coalition of TB Activists (GCTA) is a global platform of people affected by TB that amplifies community engagement and strengthens the capacity of TB activists at all levels. GCTA envisions a world free of tuberculosis and works towards making this a reality, by ensuring the voices of TB-affected communities influence the global TB and health agenda.

About Treatment Action Campaign

The Treatment Action Campaign (TAC) was founded in December 1998 to campaign for access to AIDS treatment. Today the TAC continues to represent users of the public healthcare system in South Africa, and to campaign and litigate on critical issues related to the quality of and access to healthcare. The organisation currently has over 8,000 members and a network of 182 branches and provincial offices in seven of South Africa’s nine provinces. Through its branches and members the TAC monitors thousands of clinics and hospitals. In addition to the large national campaigns, the local activism of the TAC’s members is the true life-blood of the organisation.

[1] Cepheid (Press Release). Cepheid announces updated HBDC pricing. 2021 May 6. http://cepheid.mediaroom.com/2021-05-06-Cepheid-Announces-Updated-HBDC-Pricing.

[2] TB Online. Advocates request Cepheid increase access to GeneXpert SARS-CoV-2 tests in LMICs. 2021 April. https://www.tbonline.info/posts/2021/2/25/advocates-request-cepheid-increase-access-genexper/.

[3] Cambridge Consultants/Médecins Sans Frontières. Cost of goods and manufacturing analysis of GeneXpert cartridges. 2019 March 27. https://msfaccess.org/sites/default/files/2019-12/2018%20COGS%20analysis%20of%20Xpert%20MTB_RIF%20Ultra%20cartridges.pdf.

[4] Foundation for Innovative New Diagnostics (FIND) [Internet]. GeneXpert negotiated prices. https://www.finddx.org/pricing/genexpert/.

[5] Ketchum K. Demand for Cepheid SARS-CoV-2 point-of-care tests expected to continue through 2022. 360DX.  2021 Apr 22. https://www.360dx.com/covid-19/demand-cepheid-sars-cov-2-point-care-tests-expected-continue-through-2022#.YJFNO31KjUJ.

[6] TB Online. Time to lower the price of Xpert cartridges to $5. 2020 April. http://tbonline.info/posts/2020/4/4/time-lowerprice-xpert-cartridges-us-5/.

Source: Treatment Action Group