Stocking NTEP drugs in private sector-Overview and significance

Overview of National TB Elimination Program (NTEP) Drug Logistics for Private Sector

The partnership option envisioned under NTEP should ensure an uninterrupted supply of anti-TB drugs at the state/ district/ sub-district and facility level for private sector facilities.

• For private practitioners/ medical stores/ other partners registered as Peripheral Health Institute (PHI) under Ni-kshay, drugs will be issued from their concerned TB Units (TUs).
• For non-registered private practitioners/ medical stores/ other partners under Ni-kshay, drugs will be issued as a third-party option and consumption of same should be recorded as ‘Misc. Consumption’ in Ni-kshay Aushadhi.
• The drugs are to be supplied to the private sector not more than twice a month.

Significance of stocking drugs in the private sector

• >40% of the patients in India attend private healthcare facilities initially for TB care and nearly 50% of the retreatment cases notified under NTEP are treated in the private sector before reaching NTEP. This data suggests inadequate TB treatment and could potentially develop drug resistance.
• Additionally, gaps in TB care cascade and subsequent delays in treatment initiation have also been associated with private providers.
• With the implementation of Universal Health Coverage (UHC), India has been working relentlessly to ensure that everyone receives healthcare services with minimum out-of-pocket expenditure.
• With the same motive, the NTEP recommends that all TB patients who seek care in the private sector in India also come under the ambit of the programme and should have access to the same quality of diagnostics, drugs and community-based services as public-sector patients.
• In a vast country like India, exploring partnerships with private sector service providers can strengthen supply chain management and ensure last-mile delivery of drugs.
• Therefore, provision for availing correct TB treatment from the private sector should be a fundamental right of every TB patient and is an important consideration with respect to reducing the incidence of drug-resistant TB in India as well as bettering the TB treatment outcome. Hence, it is also essential to stock NTEP drugs in the private sector.

Resources

• Guidelines on Programmatic Management of Drug-resistant TB (PMDT) in India; CTD, MoHFW, India, 2021.
• Procurement, Supply Chain Management & Preventive Maintenance, Module 6; CTD, MoHFW, India.
• From Where are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-sectional Community-based Survey of 30 Districts;PLoS One, 2011.
• The Number of Privately-treated Tuberculosis Cases in India: An Estimation from Drug Sales Data. Lancet Infectious Disease, 2016.

Assessment