Pharmacokinetic Enhancement of Elexacaftor/Tezacaftor/Ivacaftor for Cystic Fibrosis: A Cost Reduction Strategy to Address Global Disparities in Access

In this perspective, we highlight the significant global disparities encountered since the introduction of elexacaftor/tezacaftor/ivacaftor, which have largely excluded the cystic fibrosis population in low to middle income countries. We propose a pharmacokinetic (PK) enhancement strategy developed using physiologically- based pharmacokinetic (PBPK) modeling, to mitigate the high cost of treatment. The aim of this paper is to raise awareness of global monopoly concerns and provide a clinical practice strategy to effectively address the issue.