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

Dabas, H and Deo, S and Sabharwal, M and Pal, A and Salim, S and Nair, L and Chauhan, K and Maheshwari, P and Parulkar, A and Singh, R and Chitalia, M and Kadam, R and Kaur, M and Oghor, C and Ponnudurai, N and Kumta, S and Small, P and Dewan, P and Pai, M (2019) Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India. BMJ global health, 4 (6). e001539. ISSN 2059-7908

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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.

Affiliation: Indian School of Business
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Deo, S
Item Type: Article
Uncontrolled Keywords: Health Systems, Intervention Study, Public Health, Tuberculosis
Subjects: Health care and delivery
Depositing User: Gurusrinivasan K
Date Deposited: 16 May 2021 01:11
Last Modified: 16 May 2021 01:11
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