Process of preparation of boxes

Process of Preparation of Boxes

All drugs used in various Drug-resistant Tuberculosis (DR-TB) regimens under the National Tuberculosis Elimination Programme (NTEP) are supplied through a centralised procurement system at the Central TB Division (CTD).

Drug Flow under NTEP

• The Government Medical Store Depot (GMSD)/ Central Medical Services Society (CMSS) supply the loose drugs to the State drug Store (SDS).  
• The loose drugs are packed into patient-wise boxes at the SDS for various regimes.

Preparation of Patient-wise boxes under NTEP

• Preparation of patient-wise boxes is carried out mainly at the SDS and occasionally in the District Drug Stores (DDS).
• Each month, the patient in the Intensive Phase (IP) shall be put on Type A and Type B boxes.
• During the Continuation Phase (CP), the patient will be put on only Type A box for the entire duration.
• In case the regimen does not have separate IP and CP, only Type A box with all drugs is issued.
• For preparing the drug boxes, patients are classified into weight bands of <16 kg, 16-29 kg, 30-45 kg, 46-70 kg and >70kg.
• For <16 kg patients, boxes will be prepared from the loose drug provided.

Constituents of Monthly Patient-wise Box for DR-TB Patients as per Regimen and Weight Band

1. Shorter Regimen (Oral Bedaquiline-containing regimen, oral injectable regimen)

Figure 1: Constituents of monthly type A & B patient-wise box of shorter oral Bedaquiline-containing regimen and shorter injectable regimen; Source: Guidelines on Programmatic Management of Drug-resistant TB (PMDT) in India; NTEP, CTD, MoHFW, India, 2021.

2. Longer oral M/XDR-TB regimen

Figure 2: Constituents of monthly standard patient-wise box of Longer oral M/XDR-TB regimen; Source: Guidelines on Programmatic Management of Drug-resistant TB (PMDT) in India; NTEP, CTD, MoHFW, India, 2021.

3. H-mono/ poly DR-TB Regimen

Figure 3: Constituents of the monthly standard patient-wise box of H-mono/poly DR-TB regimen; Source: Guidelines on Programmatic Management of Drug-resistant TB (PMDT) in India; NTEP, CTD, MoHFW, India, 2021.

Resources

• Guidelines on Programmatic Management of Drug-resistant TB (PMDT) in India; NTEP, CTD, MoHFW, India, 2021.
• Procurement, Supply Chain Management & Preventive Maintenance, Module 6; CTD, MoHFW, India.

Assessment