The study claims that up to 22 lakh patients may have sought treatment with private doctors in 2014, spending upto Rs 395 crore as out-of-pocket expenses.
Number of patients suffering from tuberculosis in India could be much more than those previously estimated by the Government of India, according to a new study published in Lancet Infectious Diseases Journal. The study, based on sale of TB cure medicines during 2013-14, estimates the number of patients seeking treatment with private physicians could be two to three times higher.
The study claims that up to 22 lakh patients may have sought treatment with private doctors in 2014, spending upto Rs 395 crore as out-of-pocket expenses. These patients would have escaped the purview of the National TB Control Programme, run by the GoI and went unaccounted for. Only over a lakh TB cases were reported by private doctors to the government during that year, though it is mandatory for them to report cases.
In 2014, as per GoI records, 14 lakh TB patients had approached public hospitals to seek care under Revised National Tuberculosis Programme (RNTCP).
The study took into consideration the nation-wide drug sales data of 189 branded anti-TB medicines, containing components such as Isoniazid, Rifampacin, Ethambutol and Pyrazinamide, among others. The researchers then arrived at an estimate of how many patients may have been put on such treatments by private physicians during the year, by analysing the volume of drugs sold.
“An average of 22 lakh patients sought medication from private sector doctors that year. Our estimate was 8 lakh patients, and the new numbers – close to three times higher – are glaring. The under-reporting occurs as private physicians fail to report cases to the government,” said Dr Sunil Khaparde, deputy director general (TB), Ministry of Health and Family Welfare.
“These patients also ended up spending over Rs 395 crore as out-of-pocket expenses for drugs alone in 2014, when the government was offering free treatment in public sector. The annual budget of RNTCP is Rs 640 crore, which is spent on patient care as well as on drugs,” said Dr Khaparde.
Uttar Pradesh is the worst hit, with 2.45 lakh patients getting treated under RNTCP and almost a double – around 5.6 lakh – receiving treatment in the private sector under the 9-month TB drug regimen. Maharashtra is a close second with 1.33 lakh patients getting treated under RNTCP, and 1.8 lakh patients seeking private care.
“In terms of volume of TB care given by public and private sectors, Bihar recorded 3.5 times more patients approaching the private sector than the government's RNTCP. Uttaranchal comes a close second with 3.4 times receiving treatment in private sector,” said Dr Nimalan Arinaminpathy, lead author of the research, from the School of Public Health at Imperial College London.
The study further reveals that in 2014 private physicians procured nearly double the volume of drugs as compared to the government under the RNCTP.
It was estimated that in 2014, 96 lakh people fell ill with TB across the globe and 15 lakh died. The actual numbers could be much higher as there could be under-reporting in many countries, thanks to poor systems. India has the highest number of TB cases in the world.
The study on TB – a bacterial infection, spread through inhaling of tiny droplets from the coughs or sneezes of an infected person – has been jointly conducted by GoI's Central TB Division, World Health Organisation (WHO), School of Public Health at Imperial College, London, IMS Health and Bill and Melinda Gates Foundation.
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