# Diphtheria Antitoxin Production and Procurement Practices and Challenges

## TL;DR

This paper explores the challenges in producing and procuring diphtheria antitoxin, highlighting issues with availability and cost.

## Contribution

The study provides insights into the current practices and challenges in DAT procurement and monoclonal antibody development.

## Key findings

- Prices and availability of diphtheria antitoxin vary significantly.
- Manufacturers and procurement agencies struggle to predict demand for DAT.
- Monoclonal antibody developers face financial barriers in advancing their work.

## Abstract

Treatment of respiratory diphtheria requires prompt administration of equine diphtheria antitoxin (DAT) to neutralize circulating toxin. We conducted surveys of key procurement agencies and manufacturers currently engaged in DAT manufacturing or procurement, along with key informant interviews with developers of monoclonal antibodies. Our findings indicate that prices and availability of DAT vary and that prediction of demand is challenging for both manufacturers and procurement agencies. Substantial concerns were raised over the inability to obtain enough DAT to respond to increasing global outbreaks. Monoclonal antibody developers noted financial challenges in advancing their clinical and manufacturing progress.