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What are the challenges in commercial non-tuberculous mycobacteria (NTM) drug discovery and how should we move forward?

ABSTRACT Introduction: Despite the great clinical need, the development of drugs for treating non-tuberculous mycobacteria lung disease (NTM-LD), partly from the scientific difficulty, but also because the eventual size and types of markets for commercially-developed drugs has been unclear.Areas Covered: Here, key questions regarding the markets for commercial NTM-LD drugs are discussed, together with potential solutions for resolving these questions.Expert Opinion: Many of these questions will become better resoled over time, but uncertainties will remain around likely competition and whether approval and reimbursement will be achieved for all NTM-LD or smaller subsections of the market. Additionally, both ‘push’ and ‘pull’ incentives should be considered by policymakers to ensure the NTM-LD market is successfully addressed.