PONE-D-23-13904Improving the availability of antihypertensive drugs in the India Hypertension Control Initiative, India, 2019-2020PLOS ONE

Dear Dr. Kaur,

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this important piece of work, which demonstrates the feasibility of optimizing procurement and supply chains for antihypertensive drugs in India's resource-limited public sector. Please find my comments, questions, and suggestions on the attached proof of the manuscript.

Reviewer #2: The manuscript presents data and analysis that would be useful to readers, in particular health policymakers in India.

My main concern is that the conclusion and discussion of this paper is not reflective of the findings. It seems to try to gloss over procurement concerns that the data actually reveal. For example, consider the abstract's conclusions that "This study demonstrates the feasibility of strengthening the procurement and supply chain management for antihypertensive drugs." The data don't exactly demonstrate this. From table 2, I calculated that the overall percent of facilities with stockouts actually increased over the study period for both Amlo and Telmisartan. So even though the absolute quantity of pills procured did grow substantially, there were some inefficiencies still. According to figure 4, this seems to reflect issues with inadequate stock particularly of Telmisartan in 3 out of 4 examined states. For Amlo and Chlortalidone, issues with inadequate stock were observed in 1 out of 4 states.

Overall, the study demonstrates that the absolute quantities of pills did increase across the board, but some states still experienced inefficiencies with the sufficient procurement of some medicines, especially Telmisartan. The key conclusion of the paper should be to emphasize the need to resolve these stocking issues as scale up of the program increases. It's important to not bury the key take-away of the analysis just because it doesn't show perfect outcomes.

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Reviewer #1: Yes: Gautam Satheesh

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-23-13904_reviewer_Aug 9.pdf

Improving the availability of antihypertensive drugs in the India Hypertension Control Initiative, India, 2019-2020

PONE-D-23-13904R1

Dear Dr. Kaur,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Dzintars Gotham

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The comments have been sufficiently addressed. For clarity, I recommend adjusting the first sentence of the conclusion from "This study demonstrates that including best practices can gradually strengthen the

procurement and supply chain for antihypertensives in a low-resource setting."

to

"This study demonstrates an increase in health system capacity to successfully procure increased quantities of antihypertensive medications commensurate with IHCI best practices."

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Gautam Satheesh

Reviewer #2: No

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