Product Adoption and Decision-Making
Supporting a Ministry of Health's decision to incorporate products into national guidelines
To guide the adoption of and decisions around new products, programs should work collaboratively with the Ministry of Health (MoH), implementing partners, and community groups.
Product Adoption and Decision-Making Checklist
Evaluate the benefits and considerations of new products using the five lenses approach (outlined in the Product Adoption and Decision-Making Chapter)
Gather key information on the new product to build a case for its adoption and introduction (examples and samples included in resources section below)
Build consensus on product adoption by engaging key stakeholders and decision makers utilizing existing forums such as technical working groups (TWG)
Conduct a guidelines analysis and costing evaluation (e.g. using the CHAI WHO Guidelines Costing Tool)
Update national treatment guidelines based on new product decisions
Use the links below to download the entire HIV New Product Introduction Guide or the Product Adoption and Decision-Making chapter only
Product Adoption and Decision-Making Tools and Resources
In preparing for national discussions on product adoption, sufficient information on the new product should be compiled. This section outlines critical resources and tools that should be assembled and developed for sharing with key stakeholders during the technical engagement processes.
CHAI WHO Guidelines Costing Tool
The CHAI WHO Guidelines Costing Tool helps programs make decisions about how and when to adopt WHO guidelines, including high-level product phase-in strategies. The tool provides countries with an understanding of the costs of implementation and expected patient scale-up. The use of the tool is facilitated by trained CHAI staff and allows program managers to assess and compare different scenarios to answer policy questions for adults, adolescent, and pediatric guidelines. Outputs of this tool include: Costs of ARV drugs, lab commodities, and facility-level human resources. To learn more about the CHAI WHO Guidelines Costing Tool, please contact HIVToolkit@clintonhealthaccess.org.
CHAI Cost of Optimizing Second-Line Treatment (COST) Tool
The CHAI COST Tool is a model that helps to estimate the financial impact of switching existing second-line (2L) patients to optimized, clinically superior regimens. Proactively switching existing 2L patients on protease inhibitors (PIs) to more optimal regimens, such as dolutegravir (DTG), has the potential to improve clinical outcomes for patients, as well as lead to significant commodity savings for national programs. Outputs from this tool can help inform national decision-making on optimizing 2L treatment through active switching to clinically superior drugs. Further transition planning and national quantifications can help to lead to a more granular cost-savings analysis. Please reach out to Jessica Fox (email@example.com) with any questions about this tool.
Featured Product: TLD Resources
CHAI's TLD resources help countries in creating the best plan for TLD introduction. These resources can be found throughout the page, but we have also consolidated them here for your convenience:
Clinical Action Memos and Informational Briefs
Provide an overview of clinical and programmatic benefits and considerations of product adoption, summary of clinical evidence and trials, market information, phase-in strategies and FAQs for new products:
APWG LPV/r Memo (January 2019)
PowerPoint format presentations providing overview of clinical and programmatic benefits and considerations of product adoption, market factors, phase-in strategies and FAQs for key ARVs. Can be used as an information resource or adapted for presentation to multiple stakeholders:
Consolidated international recommendations and guidance regarding new ARVs should be presented during key stakeholder forums (e.g TWGs, task force meetings, etc.). Countries should consider WHO recommendations for first- and second-line ARV treatment as they make decisions for treatment options:
- WHO Guidelines on the Public Health Response to Pretreatment HIV Drug Resistance
CHAI maintains a repository of publications on relevant clinical trials and studies on new ARVs. Key information on clinical evidence and trials is also included in clinical action memos, product profiles and training materials. HIV i-base provides up to date information on the latest clinical evidence and trials on new products in their annual HIV Pipeline and Fit for Purpose publications.
CHAI’s diagnostic resources can be used across all steps of new product introduction to guide countries as they introduce point-of-care (POC) HIV technologies, HIV self-testing technologies and HIV viral load technologies into existing national diagnostic systems.
Early Infant Diagnosis
Only half of all infants born to women with HIV are tested by two months of age, and just half of those tested receive a result. Conventional early infant diagnosis (EID) relies on centralized high-throughput devices which may be located far from where parents receive care, leading to long turnaround times and high rates of loss to follow-up.
Point-of-care (POC) technologies, however, offer the opportunity to improve EID services by bringing testing closer to the patient. POC devices are robust, low-throughput platforms that can be operated by non-laboratory technicians within the clinical setting to provide results within the same day. CHAI and its partners maintain tools and resources to assist countries in introducing POC technologies for EID testing, which could help increase the number of HIV-positive infants on treatment:
HIV Point-of-Care Diagnostics Toolkit: Provides a roadmap for countries as they seek to expand access to quality assured HIV diagnostics and work toward achieving the UNAIDS 90-90-90 Fast Track HIV targets.
Market Intelligence: HIV Market Reports
Provide information on the latest developments and global outlook for the HIV treatment marketplace and product pipeline. Can be used to help stakeholders stay informed of the latest market developments and make informed decisions about national treatment options based on the global or regional outlook: