Table 2 Example for specifying dimensions of a policy’s form (Recommendation 2)

Example scenario

The World Health Organization (WHO) publishes a Model List of Essential Medicines every 2 years as a guide for countries to use when defining their own essential medicines list. A National Health Insurance Program adopts the WHO Model List of Essential Medicines to define which medicines are available to citizens under the national health plan.

EPIS framework application steps

1. Specify the policy’s origin by describing the “innovation developers” construct. Note whether innovation developers arise from the outer or inner context (see Recommendation 1).

  • The innovation developers are the WHO Expert Committee on Selection and Use of Essential Medicines, who originate in the outer context.

  • Further investigation is needed to reveal which in-country Ministry of Health stakeholders were involved in the decision to adopt the WHO policy.

2. Review legal documents to specify the policy’s structure as part of its innovation characteristics.

  • While the Model List of Essential Medicines is originally structured as a recommended guideline, a country’s adoption of this list for their national health insurance program transforms it into a law that must be adhered to until it is changed.

3. Review legal documents or conduct interviews with Ministry of Health decision-makers to assess the policy’s dynamism as part of its innovation characteristics.

  • WHO’s biennial updating of the model list suggests that the in-country law may be semi-permanent.

4. Use mixed methods to identify outcomes of policy implementation including the policy’s overall innovation fit.

  • Researchers can investigate the cost of adopting the model list on their health system (e.g., are the costs of drugs on this list aligned with the country’s existing budget for these medicines?).

  • Researchers can investigate the alignment between drugs included on the model list and the country’s disease burden.