Cargando…

Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India

A majority of patients with tuberculosis (TB) in India are diagnosed and treated in the private sector. Yet, most private providers do not use most recent WHO-endorsed microbiological tests such as liquid cultures, line probe assays and Xpert MTB/RIF due to a combination of factors such as lack of a...

Descripción completa

Detalles Bibliográficos
Autores principales: Dabas, Harkesh, Deo, Sarang, Sabharwal, Manisha, Pal, Arnab, Salim, Sachin, Nair, Lakshmi, Chauhan, Kaartikeya, Maheshwari, Prateek, Parulkar, Aparna, Singh, Ritu, Chitalia, Manasi, Kadam, Rigveda, Kaur, Manjot, Oghor, Collins, Ponnudurai, Nirros, Kumta, Sameer, Small, Peter, Dewan, Puneet, Pai, Madhukar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936393/
https://www.ncbi.nlm.nih.gov/pubmed/31908854
http://dx.doi.org/10.1136/bmjgh-2019-001539
_version_ 1783483725254754304
author Dabas, Harkesh
Deo, Sarang
Sabharwal, Manisha
Pal, Arnab
Salim, Sachin
Nair, Lakshmi
Chauhan, Kaartikeya
Maheshwari, Prateek
Parulkar, Aparna
Singh, Ritu
Chitalia, Manasi
Kadam, Rigveda
Kaur, Manjot
Oghor, Collins
Ponnudurai, Nirros
Kumta, Sameer
Small, Peter
Dewan, Puneet
Pai, Madhukar
author_facet Dabas, Harkesh
Deo, Sarang
Sabharwal, Manisha
Pal, Arnab
Salim, Sachin
Nair, Lakshmi
Chauhan, Kaartikeya
Maheshwari, Prateek
Parulkar, Aparna
Singh, Ritu
Chitalia, Manasi
Kadam, Rigveda
Kaur, Manjot
Oghor, Collins
Ponnudurai, Nirros
Kumta, Sameer
Small, Peter
Dewan, Puneet
Pai, Madhukar
author_sort Dabas, Harkesh
collection PubMed
description A majority of patients with tuberculosis (TB) in India are diagnosed and treated in the private sector. Yet, most private providers do not use most recent WHO-endorsed microbiological tests such as liquid cultures, line probe assays and Xpert MTB/RIF due to a combination of factors such as lack of awareness, misaligned incentives and high prices that are unaffordable for patients. We designed a market-based approach to transform a high-price, low-volume market equilibrium into a low-price, high-volume equilibrium to improve the uptake of these tests. Toward this end, a non-profit consortium of private laboratories, called Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT) was formed in India in March 2013. It negotiated lower pricing on equipment and reagents with manufacturers, closer to that offered to the public sector. In return, IPAQT assured that this discount was passed on to patients, who typically paid for these tests out of their pockets, through an informally agreed on retail ceiling price. IPAQT also invested in demand generation activities that complemented the supply-side effort. IPAQT membership grew from 56 laboratories in 2013 to 211 in 2018. During this period, the initiative resulted in a 10-fold increase in the uptake of Xpert and a 30%–50% reduction in price. This initiative is planned to be expanded to other South Asian countries with similar TB epidemic and private market structure and dynamics. However, long-term sustainability of the initiative would require developing more cost-effective marketing activities and integration with broader private sector engagement agenda of the national TB programme.
format Online
Article
Text
id pubmed-6936393
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-69363932020-01-06 Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India Dabas, Harkesh Deo, Sarang Sabharwal, Manisha Pal, Arnab Salim, Sachin Nair, Lakshmi Chauhan, Kaartikeya Maheshwari, Prateek Parulkar, Aparna Singh, Ritu Chitalia, Manasi Kadam, Rigveda Kaur, Manjot Oghor, Collins Ponnudurai, Nirros Kumta, Sameer Small, Peter Dewan, Puneet Pai, Madhukar BMJ Glob Health Practice A majority of patients with tuberculosis (TB) in India are diagnosed and treated in the private sector. Yet, most private providers do not use most recent WHO-endorsed microbiological tests such as liquid cultures, line probe assays and Xpert MTB/RIF due to a combination of factors such as lack of awareness, misaligned incentives and high prices that are unaffordable for patients. We designed a market-based approach to transform a high-price, low-volume market equilibrium into a low-price, high-volume equilibrium to improve the uptake of these tests. Toward this end, a non-profit consortium of private laboratories, called Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT) was formed in India in March 2013. It negotiated lower pricing on equipment and reagents with manufacturers, closer to that offered to the public sector. In return, IPAQT assured that this discount was passed on to patients, who typically paid for these tests out of their pockets, through an informally agreed on retail ceiling price. IPAQT also invested in demand generation activities that complemented the supply-side effort. IPAQT membership grew from 56 laboratories in 2013 to 211 in 2018. During this period, the initiative resulted in a 10-fold increase in the uptake of Xpert and a 30%–50% reduction in price. This initiative is planned to be expanded to other South Asian countries with similar TB epidemic and private market structure and dynamics. However, long-term sustainability of the initiative would require developing more cost-effective marketing activities and integration with broader private sector engagement agenda of the national TB programme. BMJ Publishing Group 2019-11-28 /pmc/articles/PMC6936393/ /pubmed/31908854 http://dx.doi.org/10.1136/bmjgh-2019-001539 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Practice
Dabas, Harkesh
Deo, Sarang
Sabharwal, Manisha
Pal, Arnab
Salim, Sachin
Nair, Lakshmi
Chauhan, Kaartikeya
Maheshwari, Prateek
Parulkar, Aparna
Singh, Ritu
Chitalia, Manasi
Kadam, Rigveda
Kaur, Manjot
Oghor, Collins
Ponnudurai, Nirros
Kumta, Sameer
Small, Peter
Dewan, Puneet
Pai, Madhukar
Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title_full Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title_fullStr Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title_full_unstemmed Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title_short Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
title_sort initiative for promoting affordable and quality tuberculosis tests (ipaqt): a market-shaping intervention in india
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936393/
https://www.ncbi.nlm.nih.gov/pubmed/31908854
http://dx.doi.org/10.1136/bmjgh-2019-001539
work_keys_str_mv AT dabasharkesh initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT deosarang initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT sabharwalmanisha initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT palarnab initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT salimsachin initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT nairlakshmi initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT chauhankaartikeya initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT maheshwariprateek initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT parulkaraparna initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT singhritu initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT chitaliamanasi initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT kadamrigveda initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT kaurmanjot initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT oghorcollins initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT ponnudurainirros initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT kumtasameer initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT smallpeter initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT dewanpuneet initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia
AT paimadhukar initiativeforpromotingaffordableandqualitytuberculosistestsipaqtamarketshapinginterventioninindia