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PSM - Selection

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Product selection refers to the process by which health programs select and ultimately procure the “right” health products that will be used at different levels of the health system. The selection of health products has a considerable impact on the efficacy of interventions, quality of care and cost-effectiveness.

Essential medicines are those that satisfy the priority health care needs of the population. Essential medicines are selected with due regard to disease prevalence and public health relevance, evidence of clinical efficacy and safety, and comparative costs and cost-effectiveness. Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford. WHO definition

Key policy issues in the Selection of Essential Medicines
  • Access to essential medicines depends on four factors: rational selection, affordable prices, sustainable financing and reliable health systems.
  • The selection of essential medicines, preferably linked to standard clinical guidelines, is a crucial step in ensuring access to health care and in promoting rational use by health professionals and consumers.
  • Official adoption of the essential medicines concept identifies priorities for government involvement in the pharmaceutical sector in general, and for medicine supply in the public sector and medicine benefits as part of health insurance in particular.
  • Establishment of systematic and transparent procedures for defining the national list(s) of essential medicines, on the basis of evidence-based treatment guidelines.

Source: The Selection of Essential Medicines, WHO, 2002

UNDP's support

As an interim Principal Recipient (PR) of Global Fund grants, UNDP supports Ministries of Health in the selection of quality-assured medicines, recommended in the current national guidelines, in the WHO Standard Treatment Guidelines and/or the WHO Essential Medicines List.
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Similarly, for the selection of health products such as diagnostics, bed nets, insecticides, condoms, the selection is based on the WHO recommendations for use and for quality assurance standards. UNDP also supports together with other partners, in-country selection of equipment and diagnostics for the improvement of central and peripheral laboratories.

Recently, a number of Middle Income Countries approached UNDP for health procurement with state funds. Support is being provided to clarify specifications for health products, and to select the most appropriate strengths and formulation for cancers and other Non Communicable Diseases (NCDs) medicines. WHO recommendations and standard treatment guidelines are used in the first instance to guide the selection of health products for diagnosis and treatment of specific diseases.

Selection and procurement of health products are done in compliance with national standard treatment guidelines and national regulations.

UNDP's offer

Service level agreements between UNDP and countries relating to health procurement entails iterations with the country counterparts to define clear specifications of required health products and to select the most appropriate formulations and strengths of medicines.
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UNDP selection of medicines, diagnostics and medical devices to be procured entails quality assurance standards. Among the UN agencies, WHO is mandated to support countries in the development of evidence-based guidelines and in the review of national essential medicines lists.

Guidance

WHO has established the WHO Model Lists of Essential Medicines for adults and children, which are regularly updated every two years and act as tools for the selection of medicines jointly with WHO Standard Treatment Guidelines developed for specific diseases and conditions.

WHO has also developed several evidence-based recommendations for the selection and use of diagnostic tools outlining conditions for use at the different level of the health system. In May 2018, the first WHO Model List for Essential In Vitro Diagnostics has been launched.

WHO Standard Treatment Guidelines as well as WHO recommendations on diagnostics are developed using the GRADE methodology -Grading of Recommendations Assessment, Development and Evaluation. This method, which has been adopted by WHO, could be used by countries for developing guidelines or for considering other’s country guidelines for diseases, which have not yet been covered by WHO.

For additional reading on the selection of health products, the following practical guidance is proposed:

Global Fund’s selection of medicines, diagnostics and other health products for supported countries is based on principles outlined in in the following booklet