BackgroundFinancial constraints, social taboos and beliefs in alternative medicine are common reasons for delaying or not considering treatment for hepatitis C in India. The present study was planned to analyze the impact of non-banking interest free loan facility in patients affected with hepatitis C virus (HCV) in North India. MethodsThis one year observational, retrospective study was conducted in Department of Gastroenterology (January ۲۰۱۲-December ۲۰۱۳), Dayanand Medical College and Hospital Ludhiana, to evaluate the impact of program titled “Sambhav” (which provided non-banking financial assistance and counselor services) on treatment initiation and therapeutic compliance in HCV patients. Data of fully evaluated patients with chronic hepatitis, and/or cirrhosis due to HCV infection who were treated with Peginterferon alfa and ribavirin (RBV) combination during this duration (۲۰۱۲-۲۰۱۳) was collected from patient medical records and analyzed. In the year ۲۰۱۲, eligible patients who were offered antiviral treatment paid for treatment themselves, while in ۲۰۱۳, ‘Sambhav’ program was launched and this provided interest free financing by non-banking financial company (NBFC) for the treatment of HCV in addition to free counselor services for disease management. The treatment initiation and compliance rates were compared between the patients (n = ۵۸۵) enrolled in ۲۰۱۳ who were offered ‘Sambhav’ assistance and those enrolled in ۲۰۱۲ (n = ۶۲۸) when ‘Sambhav’ was not available. ResultsIntroduction of Sambhav program improved the rates of treatment initiation (۵۹% in ۲۰۱۳ vs. ۵۱% in ۲۰۱۲, P = .۰۰۴). Of the ۵۸۵ eligible patients offered ‘Sambhav’ assistance in ۲۰۱۳, ۲۳۳ patients (۳۹.۸%) applied but ۱۰۶/۲۳۳ (۴۵.۴%) received assistance. Antiviral therapy was started in ۹۳/۱۰۶ (۸۷.۷%) of these patients, while only ۵۲ (۴۲.۵%) of ۱۲۷ patients whose applications were rejected underwent treatment. Compliance to antiviral therapy also improved with the introduction of ‘Sambhav’ program (۸۷.۷% vs. ۷۴.۱%, P = .۰۰۱). Conclusion‘Sambhav’ program had significant impact on the initiation of antiviral therapy by overcoming the financial hurdles. The free counselor services helped to mitigate social taboos and imparted adequate awareness about the disease to the patients. Initiatives like ‘Sambhav’ can be utilized for improving healthcare services in developing countries, especially for chronic diseases.
