title: Market size and sales pattern of tuberculosis drugs in the Philippines.
abstract: OBJECTIVE
  To identify the availability, types and quantity of anti-tuberculosis drugs in the public and private sectors from 2007 to 2011 in the Philippines.
  
  
  METHODS
  Analysis of the procurement of and sales data on anti-tuberculosis drugs from both the public and private sectors from 2007 to 2011.
  
  
  RESULTS
  Publicly procured anti-tuberculosis drugs were sufficient to treat all reported new tuberculosis (TB) cases from 2007 to 2011 in the Philippines. Nevertheless, the volume of anti-tuberculosis drugs in the private sector would have sufficed for the intensive phase of treatment for an additional 250 000 TB patients annually, assuming compliance with national treatment guidelines. Fixed-dose combination drugs comprised the main bulk (81%) of private market sales, while sales of loose drugs decreased over the years. Combining public and private sales in 2011, 484 725 new TB patients, i.e., 2.4 times the number of notified cases, could have been placed on treatment and treated for at least the intensive phase. Key second-line drugs are not available in the private market, making it impossible to design an adequate treatment regimen for multidrug-resistant TB (MDR-TB) in the private sector.
  
  
  CONCLUSIONS
  An enormous quantity of anti-tuberculosis drugs was channelled through the private market outside the purview of the Philippine National Tuberculosis Control Program, suggesting significant out-of-pocket expenditure, severe underreporting of TB cases and/or misuse of drugs due to overdiagnosis and overtreatment.
authors.affiliation: Stop TB Unit, World Health Organization, Western Pacific Regional Office, Manila, The Philippines.
authors.forename: T
authors.initials: T
authors.lastname: Islam
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: van Weezenbeek
authors.affiliation: National Center for Disease Prevention and Control, Department of Health, Manila, The Philippines.
authors.forename: R
authors.initials: R
authors.lastname: Vianzon
authors.affiliation: National Center for Disease Prevention and Control, Department of Health, Manila, The Philippines.
authors.forename: A M C G
authors.initials: AM
authors.lastname: Garfin
authors.affiliation: Stop TB Unit, World Health Organization, Western Pacific Regional Office, Manila, The Philippines.
authors.forename: T
authors.initials: T
authors.lastname: Hiatt
authors.affiliation: World Health Organization, WHO Representative Office Philippines, Manila, The Philippines.
authors.forename: W J
authors.initials: WJ
authors.lastname: Lew
authors.affiliation: Essential Medicines and Health Technologies Unit, World Health Organization, Western Pacific Regional Office, Manila, The Philippines.
authors.forename: K
authors.initials: K
authors.lastname: Tisocki
keywords: fixed-dose combination; multidrug-resistant tuberculosis; private sector; public-private mix