How Specials Can Deliver Value to the NHS | Page 21

Any supply chain issues for medicines in a disease area which is highly
contagious and causes significant morbidity will have an adverse impact on
patient outcomes and management. NICE has provided clear guidance on
clinical diagnosis and management of tuberculosis34. Almost 9,000 new cases
of TB occur across the UK every year33.
Please also refer to Assessing clinical need on page 6.

Cost-effectiveness and quality of life improvements
Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets
from the coughs or sneezes of an infected person. It is a serious condition but
can be cured with proper treatment35. In 2011, 8,963 cases of TB were reported
in the UK36. Of these, more than 6,000 of these cases affected people who
were born outside the UK36. It is estimated that one-third of the world’s
population is infected with latent TB. About 10% of those infected with latent
TB will become active at some point36.
Within this context, there is still a clinical need for tuberculosis medicines to
be available to patients. If there are supply issues, there is a risk of not only
a lack of treatment options but also a greater risk of spread of the disease.
TB is completely curable if the correct drugs are taken for the correct length
of time. Before drug treatment for TB nearly half of all persons with active
tuberculosis died from it35.
A carefully coordinated strategy is crucial to minimise the risk of resistance
to anti tuberculosis drugs, since resistance substantially increases the risk
of failure and cost of treatment. In the UK, treatment of a typical case
of tuberculosis is estimated to cost £5,000; however, a case of multidrugresistant tuberculosis costs between £50,000 and £70,000 (or £100,000
in the case of more broadly resistant variants such as extensively drugresistant tuberculosis)37.

CASE STUDY 7

Assessing clinical need – additional advice

Non-availability
of licensed/
fragile supply
chain in high-risk
disease areas

So a reliable supply of appropriate antibiotics to both children and adults
is critical. Unlicensed Specials offer treatment where there are no available
licensed products, often to treat children with TB.

32. Procurement experts collaborate to address TB medicine shortages. T