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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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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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 |
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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 |
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