The Initiative for Promoting Affordable and Quality Tests (IPAQT), a consortium of private sector diagnostic laboratories, will now offer the World Health Organisation (WHO)-endorsed GeneXpert HCV and HIV viral load tests at less than 50 per cent of the market price in India. India, experts said, has the third largest HIV (human immunodeficiency virus) epidemic in the world with an estimated burden of over two million. HCV (hepatitis C virus) infection is estimated to be as high as 8 to 12 million. Reducing the cost of these diagnostic tests will enhance accessibility and result in timely diagnosis and improved patient outcomes, they added.
Dr Madhukar Pai, a global healthcare leader and director of McGill Global Health Programs at McGill University, Canada, told The Indian Express via email, “Patients rarely come with a single problem, and diagnostic labs need to offer a variety of tests to diagnose and manage. Today, we have many multi-disease diagnostic technologies, and it is pointless to use them to just diagnose a single disease. If we fully leverage the potential of such multi-disease platforms, we can increase efficiency, save operational costs for labs and diagnostic costs for patients, increase patient access, and ultimately improve quality of patient care. I am pleased that IPAQT has gone beyond tuberculosis testing to introduce subsidized HIV and HCV tests.”
In 2013, with the support from the Clinton Health Access Initiative Inc. (CHAI), some of the largest diagnostic laboratories in India came together to start an Initiative for Promoting Affordable and Quality Tests (IPAQT) and offer TB diagnostic tests at affordable prices.
Currently, the consortium has almost 200 members who offer WHO-endorsed TB tests, such as GeneXpert, Hain LPA, BacTALERT 3D, and MGIT. IPAQT laboratories have increased the adoption of quality TB tests from 28,000 in 2013 to over 2,40,000 tests in 2017.
Now, IPAQT has been successful in negotiating with Cepheid, manufacturer of the GeneXpert platform, to significantly reduce the price for these critical diagnostic tests. IPAQT laboratories and hospitals can now offer the GeneXpert HCV and HIV viral load tests at no more than Rs 2,600 (US$40) and Rs 2,800 (US$43) respectively, while the market rate for these tests vary between ?4500 (US$69) and Rs 7,000 (US$108).
“IPAQT has been instrumental in providing low cost TB diagnosis using the latest molecular technology in India. Adding newer assays for HIV and HCV viral load will go a long way in providing low cost, quality reports and will enhance report standardisation irrespective of the lab performing it. The system is a walkaway platform with minimal hands on interaction from technicians.” said Dr Ajay Phadke, head of Dr Avinash Phadke SRL Diagnostics based out of Mumbai.
India accounts for 23 per cent of global tuberculosis (TB) incidence with an estimated 2.2 million cases reported in 2014 and a 2.2 per cent rate of multi-drug resistance. While India’s Revised National Tuberculosis Control Program (RNTCP) offers a 100 per cent geographic reach, numerous studies indicate that more than 50 per cent of patients seek care in the largely unregulated private sector where poor regulation and complex financial incentives can prevent access to high-quality TB tests.
IPAQT has generated accurate diagnoses for more than 290,000 individuals suspected of TB at a comparable price to non-WHO-endorsed tests that may not have provided accurate diagnosis. The model also piloted approaches to improve link to public sector treatment and facilitate government notification of more than 20,000 confirmed TB patients.