Patients with cystic fibrosis are traveling to Bangladesh to purchase Triko, a generic version of the life-extending drug Trikafta, to bypass high costs and limited availability in their home countries. While Vertex Pharmaceuticals sells a year’s supply of Trikafta for approximately $346,000 in the United States, Beximco Pharmaceuticals offers Triko for a fraction of that price, leveraging Bangladesh’s status as a least-developed country exempt from certain international patent laws.
Why are patients traveling to Dhaka for medication?
Patients are seeking affordable alternatives because Vertex Pharmaceuticals has not registered Trikafta in many lower-income nations, according to company reports and patient advocacy groups. For families like the Lotterings from South Africa, the cost of the branded drug—roughly $150,000 annually—is prohibitive. By traveling to Dhaka, these families can access Triko, which costs roughly $6,350 for children and double that for adults, according to Beximco Pharmaceuticals. This practice relies on personal-use exemptions in international patent law, which often allow individuals to transport generic medications across borders for their own treatment.

Bangladesh is classified as a “least-developed country” by the World Trade Organization, a status that grants it specific exemptions from enforcing pharmaceutical patents. This allows local companies like Beximco to reverse-engineer and produce generic versions of high-cost, patented medications.
How does the cost of generic Triko compare to branded Trikafta?
The price disparity between the two versions of the drug is significant. Vertex Pharmaceuticals, the Boston-based manufacturer of Trikafta, reports $49 billion in revenue from the drug since its 2019 launch, maintaining a high price point in wealthy markets. In contrast, Beximco’s Triko is priced to reach patients who are otherwise excluded from Vertex’s patient assistance programs. Heather Nichols, a spokesperson for Vertex, stated that the company provides Trikafta at no charge to more than 7,000 people globally, but patient advocates argue this leaves thousands of others without access. The following table illustrates the stark difference in accessibility models:

| Drug Version | Manufacturer | Estimated Annual Cost |
|---|---|---|
| Trikafta | Vertex Pharmaceuticals | ~$346,000 |
| Triko | Beximco Pharmaceuticals | ~$6,350 – $12,700 |
What are the risks of using non-approved generic drugs?
Regulatory approval remains a primary concern for medical professionals. While Beximco’s Triko is approved by Bangladesh’s national drug regulator, it has not received clearance from the U.S. Food and Drug Administration or the World Health Organization, according to industry records. Vertex spokesperson Heather Nichols highlighted that Trikafta’s safety and efficacy are backed by over 200 clinical trials across 24 countries, an investment level she notes generic manufacturers typically do not replicate. Despite these risks, parents of children like Aadil Rahman in Dhaka report immediate physical improvements, including a reduction in mucus production, shortly after beginning the generic treatment.
Patients considering international importation of medications should consult with their local healthcare providers to monitor for potential side effects and ensure dosage consistency, as regulatory oversight varies significantly by region.
Future trends in global pharmaceutical access
The emergence of “buyers clubs” and international supply networks points to a growing trend in patient-led drug access. Aayyush Goyal, founder of Eudaico Health, reports receiving roughly six inquiries daily from patients seeking information on shipping Triko. This model mirrors previous efforts to secure access to hepatitis C treatments, where Beximco also produced low-cost generics. As more patients connect through online forums, the pressure on pharmaceutical companies to either lower prices or expand donation programs in developing countries is expected to intensify.

Frequently Asked Questions
- Is it legal to import Triko for personal use? Many countries have exemptions allowing individuals to import small quantities of medication for personal use, though specific customs regulations vary by nation.
- Why hasn’t Vertex registered Trikafta in all countries? Vertex has not publicly detailed its registration strategy for every market, though the company maintains that it provides the drug to 75 countries through sales or donation programs.
- Does Triko have the same ingredients as Trikafta? Triko is a generic version of Trikafta, meaning it is designed to replicate the chemical composition of the original drug as verified by the Bangladeshi manufacturer.
Have you or a family member struggled to access life-saving medications? Share your experience in the comments below or subscribe to our newsletter for updates on global health policy and pharmaceutical reform.
