Pharmacist/ Storekeeper (SDS)

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Recording Box Preparation in Ni-kshay Aushadhi

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

There are two types of monthly Patient Wise Boxes (PWB) issued to the TB patients.

1) Type A: Contains oral drugs that are used for treatment during both the Intensive Phase (IP) and Continuation Phase (CP).

2) Type B: Contains injectables which are prescribed for Intensive Phase (IP) only

Based on the regimen and weight band of the patients , PWB are prepared and issued to the patients.

Contents of PWB

Importance of Labelling the Drug Boxes

• It helps to identify regimen-wise boxes quickly
• It helps the storekeeper in practising the First Expiry First Out (FEFO) principle
• Ensures better inventory management
• Strengthens the tracking and supply chain through the bar code present on the label

Contents of the label

In the National Tuberculosis Elimination Programme (NTEP), packaging of loose drugs into Type A, B & C boxes are done at the State Drug Stores (SDSs) under the guidance of the State TB Officer (STO)/ Medical Officer (MO)/ Drug logistics in-charge.

Specifications for packaging of patient-wise monthly drug box

Common for both Type A and Type B boxes

Packaging involves the process of packing loose second-line anti-TB drugs into one-monthly Patient-wise Boxes (PWBs) also known as the standardised drug boxes for shorter, longer Multidrug/ Rifampicin-resistant TB (MDR/RR-TB) and for H-mono/ poly Drug-resistant TB (DR-TB) regimen.

Cartridge-based Nucleic Acid Amplification Testing (CBNAAT) cartridges and Truenat chips are used in the molecular test for TB diagnosis.

• Delamanid (Dlm) is  a second line anti TB drug for Drug Resistant (DR) TB patients, supplied in the form of strips containing 8 tablets having dosage strength of 50mg with 60 months of shelf life. According to National TB Elimination Program (NTEP) guidelines, total 84 strips of Dlm tablets (672 tablets) are required to complete a full course for a patient (i.e, 100mg BD daily dosage) for 6 months of Intensive Phase (IP).

Bedaquiline (Bdq) is a group A second line drug supplied as a jar containing 188 tablets having dosage strength of 100mg with 24 months of shelf life. The jar contains the dosages for entire 6 month of treatment duration.

Flow of Bedaquiline (Bdq) drug in NTEP