Background

India bears the largest burden of TB in the world, accounting for over 28% cases. While the public sector offers structured care under NTEP, the private sector remains the first point of contact for 50-80% of the patients. Through Patient Provider Support Agency (PPSA) model under Joint Effort for Elimination of TB (JEET), the government aims to address these key inefficiencies in TB care cascade and build program management capacity by i) integration of private sector in TB care, ii) facilitating access to NTEP approved TB diagnostics iii) nationwide access to free early treatment via private sector. JEET engages agencies at the district level to engage and work closely with the patients, private clinics, providers, and NTEP to facilitate end-to-end services.

William J. Clinton Foundation (WJCF) under JEET implemented two pilot programmes with TATA-1mg from July 2020 – June 2022 under the PPSA framework. TATA-1mg is a for-profit organization specializing in e-pharmacy services. One of the models included Drug delivery partnership only while the other included Service and Drug delivery via TATA-1mg in addition to standard PPSA services in both. The key differences between TATA-1mg pilots and other PPSA models are (i) payment structure and (ii) services provided by the implementation agency. Although PPSAs models have been evaluated in the past, these differences necessitate another evaluation of these specific care delivery models.