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.

Click on a tile to view the latest resources

​Featured Pediatric Product:

Pediatric DTG 10 mg Dispersible, Scored (pDTG)

Helps countries in creating the best plan for pDTG introduction and transition

Costing Tool:

CHAI WHO Guidelines Costing Tool

Helps programs makes decisions about how and when to adopt WHO guidelines

​Product Profiles:

Adult and Pediatric Products

Highlights clinical and programmatic information and considerations for product adoption in PowerPoint Form

Featured Adult Tool:

Cost of Optimizing Second-Line Tool (COST)

Helps estimate the cost of switching existing second-line (2L) patients to optimal regimens

Diagnostic Resources:

New HIV and Viral Load Testing Technologies

Helps guide countries as they introduce new diagnostics into national diagnostic systems

​Normative Guidance:

WHO Guidelines

Consolidated international recommendations and guidance regarding new ARVs

Market Intelligence:

HIV Market Reports

Highlights the latest developments and global outlook for the HIV treatment marketplace

Clinical Action Memos and Briefs:

Adult and Pediatric Products

Highlights clinical and programmatic information and considerations for product adoption

Market Intelligence:

HIV Market Reports

Highlights the latest developments and global outlook for the HIV treatment marketplace

Clinical Studies:

Clinical Evidence Database

Repository of relevant publications, clinical evidence, and studies on the latest ARVs

Featured Product: Pediatric DTG 10 mg Dispersible, Scored Resources

CHAI's pediatric DTG 10 mg Dispersible, Scored (pDTG) resources help countries in creating the best plan for pDTG introduction and transition.

 

Featured Adult Tool:

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 (jfox@clintonhealthaccess.org) with any questions about this tool.

 
 

Market Intelligence: HIV Market Reports

Costing Tool:

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.

TAB 1
Treat all regimen spread for optimized regimen with proactive 2018 switch to TLE400
Annual Costs of Adults on Treatment for Baseline vs Test and Treat
Estimated number of adults on treatment
Cost PPPY for baseline vs test and treat
proactive switch in 2018 to DTG and TLE400
Treat all ATVr Scale Up
Total 5 Years Costs by Type of Cost
 

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:

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Product Profiles

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:

Adult

Pediatric

 

Normative Guidance

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:

Clinical Studies

 

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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.

 

Diagnostics Resources

 

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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.

 

A goal of this toolkit is to stimulate conversations between government, partners, and communities on new product introduction. Please feel free to share any thoughts, questions, or additional resources for consideration by contacting us via email at any time: HIVToolkit@clintonhealthaccess.org.

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