Laboratory assistant Iuliia Karbivska is scanning an Xpert MTB/Rif cartridge for use in the GeneXpert machine provided by MSF for the laboratory of the Zhytomyr Regional TB Dispensary. Photograph by Oksana Parafeniuk
Research article |

PLOS ONE: Public investments in the development of GeneXpert molecular diagnostic technology

Photograph by Oksana Parafeniuk
Laboratory assistant Iuliia Karbivska is scanning an Xpert MTB/Rif cartridge for use in the GeneXpert machine provided by MSF for the laboratory of the Zhytomyr Regional TB Dispensary. Photograph by Oksana Parafeniuk

In this study published in PLOS ONE, MSF and Treatment Action Group (TAG) report on the public investments made in the research and development (R&D) behind Cepheid’s GeneXpert diagnostic testing system for infectious diseases. GeneXpert test cartridges and machines are used to diagnose TB, HIV, COVID-19, viral hepatitis, sexually transmitted infections, and other diseases.

The analysis, led by TAG, found that the public invested at least US$252 million in GeneXpert R&D over the last decade. This substantial public investment stands in stark contrast to the lack of affordable pricing and favourable service-and-maintenance terms from Cepheid for GeneXpert in low- and middle-income countries.

Earlier analysis by MSF showed that it costs Cepheid less than $5 to produce one test while Cepheid is charging low- and middle-income countries a mark-up of at least 100% for TB tests and 300% for COVID-19 test. Cepheid’s profiteering during the COVID-19 pandemic is unacceptable, especially considering the massive amount of public funds that Cepheid received to develop the GeneXpert technology and roll out the system in low- and middle-income countries.- Stijn Deborggraeve, Diagnostics Advisor for Infectious Diseases, MSF Access Campaign, and study co-author