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

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Title: Tuberculosis treatment in the private healthcare sector in India: An analysis of recent trends and volumes using drug sales data
Authors: Arinaminpathy, N
Batra, D
Maheshwari, N
Swaroop, K
Sharma, L
Sachdeva, K
Khaparde, S
Rao, R
Gupta, D
Vadera, B
Nair, S
Rade, K
Kumta, S
Dewan, P
Item Type: Journal Article
Abstract: 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.
Issue Date: 31-Dec-2019
Date of Acceptance: 5-Jun-2019
ISSN: 1471-2334
Publisher: BioMed Central
Journal / Book Title: BMC Infectious Diseases
Volume: 19
Copyright Statement: © 2019 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, 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 ( applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Bill & Melinda Gates Foundation
Medical Research Council (MRC)
Funder's Grant Number: OPP1095710
Keywords: 0605 Microbiology
1103 Clinical Sciences
1108 Medical Microbiology
Publication Status: Published
Article Number: 539
Online Publication Date: 2019-06-19
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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