• The Competition Commission is investigating whether SA has been overcharged for TB drug bedaquiline.
• SA pays pharmaceutical company Johnson & Johnson R5 400 for a six-month course of the drug. 
• But other middle-income countries are able to buy the same drug for about half this amount, health advocates maintain.
• For more financial news, go to the News24 Business front page.

Bedaquiline is used to treat drug-resistant TB and SA has one of the highest burdens of the infectious disease globally. The World Health Organisation has estimated that over 50 000 South Africans died of TB in 2021 alone. 

Professor Norbert Ndjeka, director of drug-resistant TB at the National Department of Health, said he understood the commission would compare the price SA paid for the drug with what other countries were charged. 

In a briefing organised by Doctors Without Borders SA on Thursday, Njeka said the SA government was paying J&J R5 400 per patient for a six-month course of the drug. 

SA recently concluded a new deal with Johnson & Johnson to pay R5 500 for a six-month regimen of the drug from 1 October. The new price would be valid for the next two years. 

Health advocates, however, have questioned why SA is paying about twice as much as other low- and middle-income countries.

In July, around the time that SA was wrapping up its talks for the latest bedaquiline price hike, J&J announced in would be slashing the price of bedaquiline to $130 (around R2 460) for low- and middle-income countries that buy the drug via the Stop TB Partnership's Global Drug Facility.

SA does not buy the drug via the facility, meaning it cannot benefit from the reduced pricing. The Department of Health buys the drug directly from J&J. 

Fatima Hassan, a director and founder of the Health Justice Initiative, said that in addition to claims of excessive pricing, the commission had told the advocacy group it was investigating "evergreening" by J&J. 

Evergreening refers to when pharmaceutical companies slightly modify drugs to be granted new patents. 

"Evergreening and exploitative pricing are both anticompetitive," she said.

Hassan said she understood that J&J had been informed "overnight" of the probe. 

A Competition Commission spokesperson confirmed the probe. "The commission is investigating the matter and we will soon issue a full statement."

J&J did immediately responded to a request for comment.