1. Rational Use of ARV Medicines
Dr BB Rewari, India
Objectives
Estimate number of patients on ART in private sector on the basis of ARV drugs sales
Collect information on ARV drug prescription by the private sector doctors and their availability
Methodology
Structured questionnaires and interviews with broad range of stakeholders : government, pharmaceutical companies, private doctors and retail chemists (March till May 2007)
Qualitative and quantitative estimates made based on expert opinion.
3 slides, 5 mins

2. Result
From 2006 drug sales, an estimated minimum of 30,055 patients are receiving ARVs through the private sector
Assumptions: all patients are treated correctly, with the correct prescription and have 100% adherence
However, mal-prescriptions are common in the private sector:
Assuming 25% do not prescribe correctly, then more than 37,000 patients are being given ARVs in the private sector
Assuming 50% do not prescribe correctly, then more than 45,000 patients are being given ARVs in the private sector

3. Conclusion and Recommendations
Figures on private sector treatment is likely to be higher for the following reasons:
mal-prescriptions by private sector is relatively common
Due to financial reasons, patients may not purchase the complete standard regimen or have 100% adherence since they have to bear the all costs of drugs
The reported ARV drug sales database may be incomplete
ARVs can be bought over the counter in private chemist shops
Tracking prescriptions by private sector is difficult as there are no systems to do this
Recommendations:
Engage and advocate with the private sector for rational use of ARVs
Promoting public-private partnership
Promote patient education and treatment literacy