Global access to antifungal therapy and its variable cost

Area of Science:

• Global Health
• Infectious Diseases
• Pharmacoeconomics

Background:

• Antifungal therapy is vital for treating life-threatening invasive fungal infections and reducing morbidity worldwide.
• Hundreds of millions of patients globally benefit from timely antifungal treatment.

Purpose of the Study:

• To map the global registration, availability, and daily cost of essential generic antifungal drugs.
• To identify countries with limited access to intravenous deoxycholate amphotericin B, flucytosine, oral fluconazole, and oral itraconazole.

Main Methods:

• Data were collected from public resources and local contacts for 159 countries with populations over 1 million.
• Systemic registration, availability, and daily costs of four key antifungal drugs were analyzed.

Main Results:

• Amphotericin B is unavailable in 27.1% of countries, affecting 481 million people, with prices varying widely.
• Fluconazole is widely licensed, but flucytosine is unavailable in 76% of countries, impacting 2.9 billion people.
• Significant price variations were observed for all analyzed antifungal drugs across different countries.

Conclusions:

• National governments must urgently address antifungal drug access deficiencies to improve patient outcomes.
• The striking variability in antifungal drug pricing necessitates policy interventions to ensure equitable access.