Good quality locally procured drugs can be as effective as internationally quality assured drugs in treating XXXX .

@entity1 @entity1906 @entity6371 @entity1536
BACKGROUND: Owing toGiven the high costs of drugs to treat @entity6371 ( @entity6371 ), the Green Light Committee (GLC) initiative enables @entity1906 programs to procure quality-assured drugs at reduced prices. Despite price reductions, internationally quality assured (IQA) drugs can be more expensive than locally procured drugs. There is little evidence to inform decision-makers about whether IQA drugs are more effective than local drugs. This is the first study to compare outcomes between @entity6371 @entity1 treated using IQA, and locally procured drugs in the same hospitals during the same time period. METHODS/FINDINGS: A retrospective cohort study was conducted in three hospitals across Pakistan. Data on baseline characteristics and treatment outcomes during the first six months of treatment were extracted from hospital records of adult culture-positive pulmonary @entity6371 @entity1 starting treatment between January 2011 and June 2012. Two cohorts were defined: @entity1 receiving IQA drugs, and @entity1 receiving locally procured non-IQA drugs. Data were analysed using Kaplan-Meier curves and Cox proportional hazards regression. The primary outcome compared between cohorts was time to culture conversion. Of 231 @entity1 , 90 were in the IQA and 141 in the non-IQA cohorts. Baseline characteristics were similar except for higher frequency of @entity1536 resistance in the IQA cohort. Overall, 193 @entity1 (84%) culture converted. Culture conversion was not faster in the IQA cohort; the median time was 81 and 68 days in the IQA and non-IQA cohorts, respectively. Unadjusted and adjusted hazard ratios for culture conversion in IQA verses non-IQA cohorts were 0.82 (95%-CI, 0.62-1.10) and 0.95 (95%-CI, 0.66-1.36) respectively. CONCLUSIONS: Use of good quality, locally procured drugs can be effective in treating @entity6371 , may involve lower costs than using IQA drugs and could strengthen developing country drug quality assurance systems. This may be a suitable alternative in lieu of or whilst awaiting arrival of internationally procured medicines.
