Alberta gets better access to new tuberculosis drug
Alberta has received easier access to a tuberculosis drug that remains unlicensed in Canada but is touted to be a more successful option than the conventional treatment, the provincial health ministry says.
Rifapentine, also known by its brand name Priftin, is used to treat latent tuberculosis in populations that face a high risk of progression to an active disease, including some First Nations communities.
A course of the antibiotic can be completed by taking one dose per week for 12 weeks, substantially shorter than the standard treatment of a daily dose for nine months.
“This medication is an important tool,” Alberta Health said in an emailed statement. “Because treatment with rifapentine is shorter than other treatments, more patients are willing to try the treatment and finish treatment as prescribed.”
While licensed in the United States, the drug has not been approved in Canada, which means provinces and territories must apply to Health Canada to obtain it.
Alberta previously acquired rifapentine for individual patients on a case-by-case basis through the federal agency ’s Special Access Program, but this proved unwieldy in trying to keep up with new diagnoses of latent TB, the ministry said.
The province applied, and was approved, earlier this year to have the medication imported under a different Health Canada program called Access to Drugs in Exceptional Circumstances.
To be eligible, a jurisdiction must notify the federal health minister of an “urgent public health need” for a drug, according to Health Canada’s website.
However, the provincial health ministry insisted that such a declaration does not mean any particular crisis is underway. Instead, the use of the federal program is simply a “legal mechanism” to get more efficient access to the medication.
About 720 doses of rifapentine were prescribed to Albertans in June, and Alberta Health Services expects to distribute the drug at the same rate in the months ahead, the ministry’s statement said.
The province pays for the medication. The health ministry said it couldn’t reveal the cost due to contracting rules, but added that rifapentine’s shorter treatment time makes it more cost-effective than the standard option.
People with latent TB have been infected with the tuberculosis bacteria, but do not have an active TB disease and cannot spread the bug to others.
About five to 10 per cent of people with untreated latent tuberculosis will develop the disease, which most often affects the lungs and can become deadly. The risk is higher for people with compromised immune systems, including those with HIV.
The World Health Organization reports an estimated 1.7 million people, including 250,000 children, died from tuberculosis in 2016 — making it one of the top 10 killers worldwide.
TB numbers in Canada are relatively low and stable.
“However, foreign-born individuals and Indigenous Albertans continue to be disproportionately represented among reported TB cases in Alberta,” the ministry’s statement said. “Reactivation from untreated and under-treated TB is a major contributor to new active TB infections, outbreaks and transmission. Reducing these latent cases through preventive therapy is essential.”
Besides Alberta, several other jurisdictions have obtained rifapentine through the Health Canada’s “exceptional circumstances” program, including Ontario, Manitoba, British Columbia, and the Public Health Agency of Canada for use in correctional facilities.