Market shaping for AT: scoping review and case study of an intervention.
Ellie Cole, Victoria Austin
PMID 42761381WHAT IT FOUND
Hearing aid prices dropped 94% in Rwanda and 96% in Iran after UNICEF added them to its supply catalogue.
Wheelchair prices fell less, averaging 34% across three countries. These gains rely on bulk public procurement, not clinical assessment or fitting.
Key findings
01Hearing aid costs dropped 94% in Rwanda and 96% in Iran following inclusion in the UNICEF supply catalogue.
02Wheelchair price reductions were more moderate, averaging 34% across Ethiopia, Zimbabwe and South Sudan.
03Catalogue prices cover the device only, excluding assessment, fitting, user training and maintenance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The scoping review was conducted by a single researcher, which may have introduced bias. The evidence base comes from a small, recurring set of authors, limiting the range of perspectives. Pricing data were limited to a few countries and products, and outliers could not be modelled. The interviews involved only eight participants, restricting generalisability. The study reports on procurement prices, not clinical outcomes or patient satisfaction.
Declared interests
The authors declared no direct financial support for the work, but the research was undertaken with support from the AT2030 programme, funded by UK International Development.
The easy way to misread this
Do not assume that lower device costs equate to better patient outcomes. The study reports procurement prices only and explicitly states that these figures exclude the cost of assessment, fitting and maintenance, which are critical for safe and effective use.