Examining Pricing and Availability for Neglected Tropical Disease Therapies in the United States.

Background: Neglected tropical diseases primarily affect vulnerable populations in low-resource settings worldwide. In the United States, neglected tropical diseases such as Chagas, soil-transmitted helminthiases, and other infections historically affected immigrants but are increasingly relevant for US residents with climate change. We examined the pricing, prescribing rates, and supply of therapies used to treat neglected tropical diseases in the United States and their implications for accessibility and patient care. Methods: A retrospective analysis of prescription rates, wholesale acquisition costs, and shortages was conducted for 11 treatment products from 2019 to 2024, aggregating data from Symphony Metys, First Databank, NAVLIN, Red Book, and the University of Utah Drug Information Service. Results: While prices for most neglected tropical diseases were stable, albendazole prices decreased by 78% while mebendazole prices rose by 60%. Miltefosine remained expensive at $48 000 per treatment course. There are limited manufacturers of neglected tropical disease treatments in the United States, increasing vulnerability to shortages. Conclusions: Addressing pricing irregularities and supply vulnerabilities requires legislative and policy interventions to enhance generic competition, expand public manufacturing, and strengthen supply chains. Such measures are critical to ensuring affordable and accessible treatment options for neglected tropical diseases in the United States.