ArticleBMJ global health2021
Engaging with the private healthcare sector for the control of tuberculosis in India: cost and cost-effectiveness.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Pooled it
- Rethinking Tuberculosis Morbidity Quantification: A Systematic Review and Critical Appraisal of TB Disability Weights in Cost-Effectiveness Analyses.PharmacoEconomics · 2024Pooled it
- Private sector engagement in tuberculosis detection: a bibliometric analysis.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Review
- Can we optimise the TB response amid funding constraints using evidence-based, cost-effective strategies.IJTLD open · 2026Article
- Enhancing TB case detection: a case study of Kenya's Global Fund-supported public-private mix.Public health action · 2026Article
- Enhancing tuberculosis care in the private sector: Role of innovative private sector engagement model under programmatic settings in India.PLOS global public health · 2026Article
- Improving private tuberculosis patient notifications in Akot Tuberculosis Unit of Vidarbha region of India: A Plan-Do-Study-Act (PDSA) based approach for enhanced public health reporting.PLOS global public health · 2026Article
- Article
- Engaging private providers to enhance tuberculosis detection and notification: evidence from TB REACH-Supported projects.BMC public health · 2025Article
- Scaling up tuberculosis case finding via private providers in Ghana: an impact evaluation using interrupted time series.Frontiers in public health · 2025Article
- Cost of TB care and equity in distribution of catastrophic TB care costs across income quintiles in India.Global health research and policy · 2024Article
- Case fatality among people with drug-susceptible TB enrolled in a private health sector TB treatment support program in Bihar, India during the first year of the COVID-19 pandemic.PLOS global public health · 2024Article
- Participation of private providers in the National TB Programme in South India.Public health action · 2023Article
- The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V.Tropical medicine and infectious disease · 2023Article
- Do private providers initiate anti-tuberculosis therapy on the basis of chest radiographs? A standardised patient study in urban India.The Lancet regional health. Southeast Asia · 2023Article
- Implementation of a tuberculosis elimination project, India 2018-2019.Bulletin of the World Health Organization · 2023Article
- India is well placed to scale innovations in tuberculosis diagnostics.The Indian journal of medical researchArticle
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundThe control of tuberculosis (TB) in India is complicated by the presence of a large, disorganised private sector where most patients first seek care. Following pilots in Mumbai and Patna (two major cities in India), an initiative known as the 'Public-Private Interface Agency' (PPIA) is now being expanded across the country. We aimed to estimate the cost-effectiveness of scaling up PPIA operations, in line with India's National Strategic Plan for TB control.
methodsFocusing on Mumbai and Patna, we collected cost data from implementing organisations in both cities and combined this data with models of TB transmission dynamics. Estimating the cost per disability adjusted life years (DALY) averted between 2014 (the start of PPIA scale-up) and 2025, we assessed cost-effectiveness using two willingness-to-pay approaches: a WHO-CHOICE threshold based on per-capita economic productivity, and a more stringent threshold incorporating opportunity costs in the health system.
findingsA PPIA scaled up to ultimately reach 50% of privately treated TB patients in Mumbai and Patna would cost, respectively, US$228 (95% uncertainty interval (UI): 159 to 320) per DALY averted and US$564 (95% uncertainty interval (UI): 409 to 775) per DALY averted. In Mumbai, the PPIA would be cost-effective relative to all thresholds considered. In Patna, if focusing on adherence support, rather than on improved diagnosis, the PPIA would be cost-effective relative to all thresholds considered. These differences between sites arise from variations in the burden of drug resistance: among the services of a PPIA, improved diagnosis (including rapid tests with genotypic drug sensitivity testing) has greatest value in settings such as Mumbai, with a high burden of drug-resistant TB.
conclusionsTo accelerate decline in TB incidence, it is critical first to engage effectively with the private sector in India. Mechanisms such as the PPIA offer cost-effective ways of doing so, particularly when tailored to local settings.
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