Labs team up to make TB, HIV tests affordable

At a time when much of the focus is on getting new tuberculosis drugs to patients, a private consortium of pathlabs is working to make quality and affordable diagnostic tests more accessible not just for TB, but also for Hepatitis C and HIV.

And this, at about half the market price, said a note from the Initiative for Promoting Affordable and Quality Tests (IPAQT). The development comes even as Prime Minister Narendra Modi inaugurates the TB Summit tomorrow in Delhi with a vision to end TB in the country by 2025.

With about 200 members, IPAQT is making available World Health Organisation (WHO)-endorsed GeneXpert HCV and HIV viral load tests at affordable prices to facilitate timely testing and accurate treatment. The consortium includes Dr Lal PathLabs, Metropolis, SRL and Thyrocare, among others.

The network has managed to bring down the price of these tests through negotiations with Cepheid, manufacturer of the GeneXpert platform. “IPAQT laboratories and hospitals can now offer the GeneXpert HCV and HIV viral load tests at no more than ₹2,600 ($40) and ₹2,800 ($43), respectively, while the market rate for these tests vary between ₹4,500 ($69) and ₹7,000 ($108),” IPAQT said.

Multi-disease platforms

Madhukar Pai, Director of McGill Global Health Programs at Canada's McGill University, explains that patients rarely present with a single problem, so diagnostic labs need to offer a variety of tests to enable disease diagnosis and management. “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.”

When TB patients are not diagnosed and cured quickly, they may unknowingly spread their infection to their families and communities, further exacerbating the epidemic, a representative familiar with IPAQT's network said, unwilling to be named. “In India, more than 60 per cent cases seek care in the private sector for tuberculosis. To achieve successful outcomes, it is important to make available diagnostic tests at affordable costs to the public,” she added.

India has the third largest HIV epidemic in the world with an estimated burden of over 2 million and the burden of HCV (Hepatitis C) infection is estimated to be as high as 8-12 million, an IPAQT note said. “Significantly reducing the cost of these diagnostic tests will enhance accessibility and result in timely diagnosis and improved patient outcomes,” it added

In 2013, IPAQT was started with support from the Clinton Health Access Initiative Inc and some of the largest diagnostic laboratories in India to offer TB diagnostic tests at affordable prices. “TB tests are available under IPAQT pricing in more than 70 per cent of Indian districts because of the IPAQT partner labs and their collection centres,” the IPAQT representative said. Access to affordable private sector testing has increased from 15 per cent to 45 per cent of the country's population, she added.

Challenges, however, remain in terms of the high utilisation of non-validated, conventional PCR in the private sector, the representative said. Nevertheless, IPAQT is looking to extend the services to other critical disease areas, she said, adding that the team was working on this and larger plans to take this service beyond Indian shores.

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