Coverage for Multidrug-Resistant Tuberculosis

Health Insurance for MDR-TB in India: Coverage, Costs & Benefits

Every year, India experiences a surge in the number of multidrug-resistant tuberculosis (MDR-TB) cases. About 26% of the population suffers from MDR-TB, making it a significant public health issue in the country. Moreover, the treatment cost of MDR-TB is significantly high in India, ranging from Rs. 4.8 lakh to Rs. 25 lakh. Therefore, it can be tricky for middle- and low-income groups to bear this treatment cost, leading to the need for comprehensive coverage for this disease.

Understanding Multidrug-Resistant Tuberculosis

Multidrug-resistant tuberculosis (MDR-TB) is a significant public health problem in India, which has the highest worldwide burden of TB cases. MDR-TB is when Mycobacterium tuberculosis develops resistance to at least isoniazid and rifampicin, the two most effective first-line anti-TB drugs.

In India, this resistance tends to develop as a result of factors like inadequate or inappropriate treatment, poor drug compliance, and inadequate healthcare infrastructure. Social stigma, poverty, and poor access to quality diagnostic centres further aggravate the problem. The Revised National Tuberculosis Control Programme (RNTCP) and the National Strategic Plan try to stem MDR-TB by early detection, free diagnosis, and access to second-line drugs.

Diagnosis of Multidrug-Resistant Tuberculosis

Diagnosis of tuberculosis (TB) in India is an integral part of the country's strategy for controlling and eliminating the disease. The Government of India, as part of the National Tuberculosis Elimination Programme (NTEP), follows a multi-level approach to early and correct diagnosis.

Sputum smear microscopy and chest X-ray are the main diagnostic techniques. In addition, molecular tests such as CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) and True Nat also provide quick and accurate detection, including drug-resistant types. Doctors use biopsy and imaging methods for extrapulmonary TB.

Limited access to quality diagnostic services creates challenges in rural and distant locations. Furthermore, social stigma and ignorance generally make patients seek medical attention late. Consolidating private providers and digital platforms like Nikshay has enhanced case notification and tracking. Investment in diagnostic facilities and community engagement is essential for successful TB control in India.

Treatment of Multidrug-Resistant Tuberculosis

The National Tuberculosis Elimination Programme (NTEP) in India handles MDR-TB treatment, offering free diagnosis and treatment to those affected. The regimen lasts 6–9 months for the intensive phase and 18 months for the continuation phase, totalling around 24–27 months of treatment.

During the intensive phase, doctors prescribe a combination of six drugs: kanamycin, levofloxacin, cycloserine, ethionamide, pyrazinamide, and ethambutol. They reserve P-aminosalicylic acid (PAS) for patients who cannot tolerate or react to other medications. Despite these treatments, difficulties remain, such as severe side effects, longer treatment courses, and problems with patient compliance.

In addition, most patients first approach care in the private sector or self-medicate, which results in delayed diagnosis and higher out-of-pocket costs. India needs to strengthen its healthcare infrastructure, improve patient support systems, and raise public health awareness to enhance the treatment outcome of MDR-TB.

Policy Coverage for Multidrug-Resistant Tuberculosis

Upon a diagnosis of TB, particularly multidrug-resistant TB, the Star Comprehensive Health Insurance Policy may provide crucial financial assistance.

• Cashless Hospitalisation: The policy covers cashless hospitalisation in Star Health's tie-up hospitals, thereby exempting the policyholder from making out-of-pocket payments in times of emergency.
• Pre- and Post-Hospitalisation Cover: It covers medical costs between 60 days before hospitalisation and 90 days after discharge.
• Ambulance Charges: The policy covers road ambulance costs (up to actuals) and air ambulance expenses under policy limits.
• Second Medical Opinion: A second opinion can be obtained from the policyholder through a specialist for clarity and confidence in treatment decisions.
• Midterm Inclusion: Spouses and newborn infants can be added midterm with a surplus premium and full family coverage.
   

Overall, multidrug-resistant tuberculosis (MDR-TB) remains a significant economic and health burden in India, especially among middle- and low-income populations. With rising cases, expensive treatment, and barriers to diagnosis and adherence, there is a pressing need for better healthcare systems and public awareness. Comprehensive health insurance policies like the Star Comprehensive Health Insurance Policy can offer vital financial support, ensuring access to quality treatment and better patient outcomes nationwide.