GeneXpert diagnostic tests are essential tools in the struggle against COVID-19, tuberculosis, HIV, viral hepatitis, and other diseases. These highly accurate rapid molecular tests enable decentralized—and therefore more accessible—automated diagnostic testing to confirm the presence of disease. The U.S.-based company Cepheid developed GeneXpert diagnostics with more than $252 million in public funding that came primarily from the U.S. government. In addition to making significant investments in GeneXpert research and development, the U.S. government is also a major purchaser of GeneXpert tests for U.S. and low- and middle-income country (LMIC) markets. Yet, despite these substantial public investments, Cepheid refuses to publicly disclose its cost of production and sells GeneXpert tests at unaffordable prices that limit access in the U.S. and in LMICs.

This brief outlines actionable steps the U.S. government can take to hold Cepheid accountable for transparent, fair, and equitable pricing of GeneXpert tests and ensure public return on public investment for health technologies developed using U.S. government funding.