Coordinated Market-Shaping Levers in Health Product Introduction: A case study from South Africa
1
Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
2
Health Economics and Epidemiology Research Office (HE2RO), Wits Health Consortium, University of the Witwatersrand, JOHANNESBURG, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Introducing new health products into South Africa’s public health sector is shaped not only by national regulatory approval and policy decisions, but also provincial purchasing practices. While products may form part of the Essential Medicines List and be awarded on national tender, each province procures its own medicines within the budget assigned by National Treasury. This reflects provincial variations in historical consumption and projected commodity uptake. These dynamics pose challenges for the introduction of new health products. This case study examines an approach utilised to support the introduction of the self-injectable, subcutaneous depot medroxyprogesterone (DMPA-SC), using a market-shaping lens to explore how provincial-level decision-making can be better aligned with national policy intent.
METHODS:
Stakeholder meetings were held across each province (8), guided by a structured questionnaire. Meetings included the Maternal, Child and Women’s Health programme, pharmaceutical services and finance teams. Meeting notes were consolidated and reviewed to identify factors influencing purchasing decisions and tools required to support provincial planning.
RESULTS:
Different levers were required for distinct stakeholder groups. Programme and pharmaceutical services leaders needed evidence linking product efficacy to clients and health system benefits, while finance teams prioritised affordability and budget impact. In response, two complementary tools were developed: a value story and province-specific budget impact models. The value story combined epidemiology, unmet clinical needs and evidence comparing DMPA-SC with existing methods. Budget impact models informed by provincial cost and volume inputs are being used by finance teams to assess affordability and inform budget and procurement planning for the upcoming fiscal year.
CONCLUSIONS:
Understanding the priorities of diverse stakeholders, can lead to tailored approaches, The value story and province-specific budget impact models are tools that can help translate national product decisions into provincial uptake. Aligning national policy intent with provincial purchasing decisions can strengthen market sustainability and access.
Introducing new health products into South Africa’s public health sector is shaped not only by national regulatory approval and policy decisions, but also provincial purchasing practices. While products may form part of the Essential Medicines List and be awarded on national tender, each province procures its own medicines within the budget assigned by National Treasury. This reflects provincial variations in historical consumption and projected commodity uptake. These dynamics pose challenges for the introduction of new health products. This case study examines an approach utilised to support the introduction of the self-injectable, subcutaneous depot medroxyprogesterone (DMPA-SC), using a market-shaping lens to explore how provincial-level decision-making can be better aligned with national policy intent.
METHODS:
Stakeholder meetings were held across each province (8), guided by a structured questionnaire. Meetings included the Maternal, Child and Women’s Health programme, pharmaceutical services and finance teams. Meeting notes were consolidated and reviewed to identify factors influencing purchasing decisions and tools required to support provincial planning.
RESULTS:
Different levers were required for distinct stakeholder groups. Programme and pharmaceutical services leaders needed evidence linking product efficacy to clients and health system benefits, while finance teams prioritised affordability and budget impact. In response, two complementary tools were developed: a value story and province-specific budget impact models. The value story combined epidemiology, unmet clinical needs and evidence comparing DMPA-SC with existing methods. Budget impact models informed by provincial cost and volume inputs are being used by finance teams to assess affordability and inform budget and procurement planning for the upcoming fiscal year.
CONCLUSIONS:
Understanding the priorities of diverse stakeholders, can lead to tailored approaches, The value story and province-specific budget impact models are tools that can help translate national product decisions into provincial uptake. Aligning national policy intent with provincial purchasing decisions can strengthen market sustainability and access.
| eISSN: | 2654-1459 |
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