Bangladesh-made generic cystic fibrosis drug slashes treatment costs worldwide

For families living with cystic fibrosis, the new Bangladesh-made generic version of Trikafta is more than a cheaper pill. It is a stark measure of how a drug priced at about $370,000 a year in the United States can be reproduced for $6,375 per child and $12,750 per adult, a drop of roughly 96% to 98%. That spread has turned a breakthrough medicine into an accountability story about pricing, patent barriers and why desperate patients have had to look overseas for standard care.

The drug at the center of the fight is elexacaftor/tezacaftor/ivacaftor, or ETI, the triple-combination cystic fibrosis modulator sold by Vertex Pharmaceuticals as Trikafta in the U.S. and Kaftrio in some other markets. The FDA approved Trikafta on October 21, 2019, first for patients 12 and older with at least one F508del mutation, before the treatment was expanded to younger patients. CFTR modulators matter because they do not just manage symptoms; they correct the faulty CFTR protein that causes the disease.

That underlying science has collided with an affordability crisis for years. In 2019, volunteer parents in the United Kingdom founded the CF Buyers’ Club after learning that cheaper, quality-assured CFTR modulators were being sold in Argentina. The group says it was created to build a lawful route to access medicines that families could not afford at branded prices. For many patients, the practical reality has meant traveling abroad, relying on informal buyers’ clubs or seeking versions sold in markets far outside their own health systems.

The pressure has also reached health authorities. NHS England said in March 2024 that since 2019 thousands of people with cystic fibrosis have benefited from licensed modulator treatments, beginning with Kalydeco in 2012, then Orkambi and Symkevi, and later Kaftrio after its 2020 authorization. But access has remained uneven, and campaigners say the cost disputes have shown how slowly a medical breakthrough can reach patients when pricing is left to the market.

Beximco Pharmaceuticals PLC, based in Bangladesh, said it has begun supplying its low-cost generic version to patients from six countries, describing the launch as a global first for an affordable alternative to Vertex’s treatment. Campaigners from groups including Right to Breathe and Just Treatment have framed the move as proof that patient pressure can force open a path around a system that has kept a life-changing drug out of reach for too many families in the United States, the United Kingdom, Brazil and beyond.