Trends of private drugs sales and costs incurred by patients on anti-tuberculosis drugs in selected districts of Jharkhand (2022): Results from sub-national TB free certification

Abstract

Background Government of India is committed to eliminate tuberculosis by 2025 under National Tuberculosis Elimination Program which provides free investigations and treatment as well as incentives for nutritional support during their treatment course.Many tuberculosis patients prefer to seek treatment fromthe private sector which sometimes leads tofinancial constraints for the patients. Our study aims to find the burden of tuberculosis patients in the private sector and the expenses borne by them for their treatment.Methodology :Sales data of Rifampicin-containing formulations drug consumption in the private sector of six districts of Jharkhand was collected from Clearing and Forwarding (C & F) agencies and drug controller office during the SNC activities in the state. Based on the drug sales data total incurring costs of the drugs, total private patient months, total number of patients and cost per patient seeking treatment from private sector were calculated for the year 2015–2021. Data collected was analysed using Jamovi and statistical test such as ANOVA and post hoc test- Tukey HSD method was applied to note the difference between districts.Results There was a marked difference amongst all the districts in relation to all the variables namely total costs, total private patient months, cost per patient and total private patients seeking treatment from the private sector which was statistically significant (p < 0.001).East Singhbhum had the highest out-of-pocket expense and private patients as compared to all 6 districts. Lohardaga showed the sharpest decline in total private patients from 2015 to 2021. The average cost borne by private patients (2015–2021) ranged from 553 INR/ 6.77 USD (Pakur) to 2441 INR/ 29.88 USD (Lohardaga).Conclusion From the study, it was concluded that purchase of medicines for tuberculosis treatment from private sector is one of theessential elements in out-of-pocket expenditure (OOPE) borne by tuberculosis patients. Hence, newer initiatives should be explored to foresee the future costs of out-of-pocket expenditure borne by the patients and decrease OOPE-induced poverty.