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Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data

BACKGROUND: There is a pressing need for systematic approaches for monitoring how much TB treatment is ongoing in the private sector in India: both to cast light on the true scale of the problem, and to help monitor the progress of interventions currently being planned to address this problem. METHO...

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Autores principales: Arinaminpathy, Nimalan, Batra, Deepak, Maheshwari, Nilesh, Swaroop, Kishan, Sharma, Lokesh, Sachdeva, Kuldeep Singh, Khaparde, Sunil, Rao, Raghuram, Gupta, Devesh, Vadera, Bhavin, Nair, Sreenivas A., Rade, Kiran, Kumta, Sameer, Dewan, Puneet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584981/
https://www.ncbi.nlm.nih.gov/pubmed/31217003
http://dx.doi.org/10.1186/s12879-019-4169-y
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author Arinaminpathy, Nimalan
Batra, Deepak
Maheshwari, Nilesh
Swaroop, Kishan
Sharma, Lokesh
Sachdeva, Kuldeep Singh
Khaparde, Sunil
Rao, Raghuram
Gupta, Devesh
Vadera, Bhavin
Nair, Sreenivas A.
Rade, Kiran
Kumta, Sameer
Dewan, Puneet
author_facet Arinaminpathy, Nimalan
Batra, Deepak
Maheshwari, Nilesh
Swaroop, Kishan
Sharma, Lokesh
Sachdeva, Kuldeep Singh
Khaparde, Sunil
Rao, Raghuram
Gupta, Devesh
Vadera, Bhavin
Nair, Sreenivas A.
Rade, Kiran
Kumta, Sameer
Dewan, Puneet
author_sort Arinaminpathy, Nimalan
collection PubMed
description BACKGROUND: There is a pressing need for systematic approaches for monitoring how much TB treatment is ongoing in the private sector in India: both to cast light on the true scale of the problem, and to help monitor the progress of interventions currently being planned to address this problem. METHODS: We used commercially available data on the sales of rifampicin-containing drugs in the private sector, adjusted for data coverage and indication of use. We examined temporal, statewise trends in volumes (patient-months) of TB treatment from 2013 to 2016. We additionally analysed the proportion of drugs that were sold in combination packaging (designed to simplify TB treatment), or as loose pills. RESULTS: Drug sales suggest a steady trend of TB treatment dispensed by the private sector, from 18.4 million patient-months (95% CI 17.3–20.5) in 2013 to 16.8 patient-months (95% CI 15.5–19.0) in 2016. Overall, seven of 29 states in India accounted for more than 70% of national-level TB treatment volumes, including Uttar Pradesh, Maharashtra and Bihar. The overwhelming majority of TB treatment was dispensed not as loose pills, but in combination packaging with other TB drugs, accounting for over 96% of private sector TB treatment in 2017. CONCLUSIONS: Our findings suggest consistent levels of TB treatment in the private sector over the past 4 years, while highlighting specific states that should be prioritized for intervention. Drug sales data can be helpful for monitoring a system as large, disorganised and opaque as India’s private sector.
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spelling pubmed-65849812019-06-27 Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data Arinaminpathy, Nimalan Batra, Deepak Maheshwari, Nilesh Swaroop, Kishan Sharma, Lokesh Sachdeva, Kuldeep Singh Khaparde, Sunil Rao, Raghuram Gupta, Devesh Vadera, Bhavin Nair, Sreenivas A. Rade, Kiran Kumta, Sameer Dewan, Puneet BMC Infect Dis Research Article BACKGROUND: There is a pressing need for systematic approaches for monitoring how much TB treatment is ongoing in the private sector in India: both to cast light on the true scale of the problem, and to help monitor the progress of interventions currently being planned to address this problem. METHODS: We used commercially available data on the sales of rifampicin-containing drugs in the private sector, adjusted for data coverage and indication of use. We examined temporal, statewise trends in volumes (patient-months) of TB treatment from 2013 to 2016. We additionally analysed the proportion of drugs that were sold in combination packaging (designed to simplify TB treatment), or as loose pills. RESULTS: Drug sales suggest a steady trend of TB treatment dispensed by the private sector, from 18.4 million patient-months (95% CI 17.3–20.5) in 2013 to 16.8 patient-months (95% CI 15.5–19.0) in 2016. Overall, seven of 29 states in India accounted for more than 70% of national-level TB treatment volumes, including Uttar Pradesh, Maharashtra and Bihar. The overwhelming majority of TB treatment was dispensed not as loose pills, but in combination packaging with other TB drugs, accounting for over 96% of private sector TB treatment in 2017. CONCLUSIONS: Our findings suggest consistent levels of TB treatment in the private sector over the past 4 years, while highlighting specific states that should be prioritized for intervention. Drug sales data can be helpful for monitoring a system as large, disorganised and opaque as India’s private sector. BioMed Central 2019-06-19 /pmc/articles/PMC6584981/ /pubmed/31217003 http://dx.doi.org/10.1186/s12879-019-4169-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Arinaminpathy, Nimalan
Batra, Deepak
Maheshwari, Nilesh
Swaroop, Kishan
Sharma, Lokesh
Sachdeva, Kuldeep Singh
Khaparde, Sunil
Rao, Raghuram
Gupta, Devesh
Vadera, Bhavin
Nair, Sreenivas A.
Rade, Kiran
Kumta, Sameer
Dewan, Puneet
Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title_full Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title_fullStr Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title_full_unstemmed Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title_short Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data
title_sort tuberculosis treatment in the private healthcare sector in india: an analysis of recent trends and volumes using drug sales data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584981/
https://www.ncbi.nlm.nih.gov/pubmed/31217003
http://dx.doi.org/10.1186/s12879-019-4169-y
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