Bangladesh-made generic cystic fibrosis drug offers global lifeline

The price gap is the fault line: Vertex Pharmaceuticals’ TRIKAFTA carries a $370,000 U.S. list price, while Beximco Pharmaceuticals PLC’s Bangladesh-made generic, TRIKO, costs $12,750 a year for adults and $6,375 for children. Beximco says the 96% cut means 58 children can be treated for the cost of one child on the branded medicine, turning a once unobtainable therapy into a realistic option for families shut out by the market.

Beximco publicly set out the plan on October 23, 2025, at the North American Cystic Fibrosis Conference in Seattle, where a coalition of parents of children with cystic fibrosis pushed for a buyer’s club to move the drug across borders at a price families could pay. The company later handed TRIKO to patients and representatives from the United States, the United Kingdom, Slovakia, Qatar, South Africa and Bangladesh on June 15, 2026, at its manufacturing facility in Dhaka, marking the first time an affordable generic version of the treatment was made available globally.

Cystic fibrosis is a rare genetic disorder that causes thick mucus to build up in the lungs and digestive system, severely impairing breathing and, until recently, often shortening lives to early adulthood. About 160,000 people worldwide are living with the disease, and another 80,000 cases are thought to remain undiagnosed. An estimated 82% of those undiagnosed cases are in low- and middle-income countries, a reminder that the burden of the disease is far larger than the number of patients already in treatment.

The legal opening comes from Bangladesh’s status as a United Nations least developed country, which under World Trade Organization TRIPS rules exempts it from enforcing pharmaceutical patents. That framework allowed Beximco to produce TRIKO with the same three active ingredients as TRIKAFTA, elexacaftor, tezacaftor and ivacaftor, even as the branded drug remains protected and out of reach for many buyers outside wealthy health systems.

The U.S. Food and Drug Administration first approved TRIKAFTA in 2019 for patients age 2 and older with at least one F508del mutation or another responsive CFTR mutation. The label also carries a boxed warning for drug-induced liver injury and liver failure, with required liver-function monitoring. For advocates such as Gayle Pledger of the U.K.-based Right to Breathe campaign, the launch showed how patient pressure can force access questions that a billion-dollar pricing system has long refused to answer.