Our preprint, Progress, Impacts and Lessons from Market Shaping in the Past Decade: A Systematic Review, reviews the progress and impacts, and identifies enablers and barriers of market shaping activities in the past decade.
Read the full article via The Lancet.
Authors: Wenhui Mao, Katharine Olson, Elina Urli Hodges, Krishna Udayakumar
Abstract
Background: Market shaping activities have been increasingly used to improve access to health products. This paper reviewed the progress and impacts, and identified enablers and barriers of market shaping activities in the past decade.
Methods: We conducted a systematic review using a structured searching strategy across five academic databases and key actors’ websites with a structured searching strategy for gray and white literature published in English between 2012-2022. Two researchers independently performed screening, data extraction and analysis. This study was registered with PROSPERO (CRD42023471098).
Findings: Following independent screening, 83 out of 2,573 articles were eligible for analysis. The majority of the articles were qualitative studies and published within the past five years. Two-thirds focused on drugs and vaccines; the leading health conditions that received market shaping interventions were infectious diseases. Market shaping interventions on manufacturing, regulatory and guidelines, and procurement were the most reported. Rapid access to new products, improved availability, and reduced product cost were the most reported impacts. Public-private partnerships, product development partnerships, advance market commitments, pooled procurement, volume guarantees, and priority review vouchers positively impacted access to products. Barriers of market shaping were the disconnection between market shaping interventions and downstream factors, fragmentation and lack of transparency in regulatory processes, and failure to incentivize manufacturers. Enablers included taking end-to-end approaches, coordination across different actors, particularly the national stakeholders and private sectors, creating transparent and predictable demand, longer time span, and flexible funding.
Interpretation: While market shaping interventions have contributed to the improvement of access to health products, more quantitative evidence, comprehensive impact evaluation, and in-depth studies on the negative impacts of market shaping are needed. Market shaping actors need to adopt definitions and frameworks, apply an ecosystem-wide lens, engage with diverse stakeholders, consider service delivery and strengthen key capabilities.
Funding: This work was supported by The Bill and Melinda Gates Foundation.