Treatment Action Group, New York, NY, USA.
Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Int J Infect Dis. 2015 Mar;32:56-60. doi: 10.1016/j.ijid.2014.12.012.
Multidrug-resistant tuberculosis (MDR-TB) is on the rise, and is difficult to treat. The approval of two new drugs, bedaquiline and delamanid, and growing evidence for the use of linezolid, offer renewed hope for addressing MDR-TB. However, access to these medicines remains a significant challenge. These drugs have not been registered for TB in most settings; barriers to preapproval access persist; and high pricing and intellectual property restrictions limit access. Many unanswered research questions about optimal use of these drugs also limit access, particularly for vulnerable populations. This review outlines challenges in accessing drugs encountered from the perspective of clinicians, patients and affected communities, and offers potential solutions.
耐多药结核病（MDR-TB）呈上升趋势，且难以治疗。两种新药贝达喹啉和德拉马尼的批准，以及利奈唑胺使用证据的不断增加，为解决耐多药结核病带来了新的希望。然而，获得这些药物仍然是一个重大挑战。在大多数情况下，这些药物尚未在结核病方面注册；预批准准入的障碍依然存在；高定价和知识产权限制限制了准入。关于这些药物最佳使用的许多未解答的研究问题也限制了准入，尤其是对弱势群体。本综述从临床医生、患者和受影响社区的角度概述了获取这些药物时遇到的挑战，并提出了潜在的解决方案。
