**11. Engagement of stakeholders for pharmaceutical policy development**

It is a common practice that governments after drafting policy documents put them in public domain either through print media or through their official websites inviting feedback and suggestions from common masses for their improvement that evokes and yields a few responses from the concerned citizens. However sufficient feedback is not received quite often reducing this whole exercise merely to a formality that hardly bears any tangible results. There is no systematic and organized engagement of various stakeholders mentioned above in some structured manner as a result of which policy document lacks in amalgamation of divergent viewpoints and cross-sectional opinions. In the fitness of things, important stakeholders mentioned above rather need to be consulted and engaged in a very sustained and systematic manner arranging their regular review meetings in clusters and allowing intense brainstorming and refining of ideas. Roberts [30] in his commentary on "Making drug policy together" has argued that stakeholder consultation is intended to inform policy by helping to provide the evidence-base for policy development on one hand and on the other, it provides an opportunity for representation of the views and experiences of a range of individuals and organizations who are interested in and/or affected by drug policy. He further argues that the use of various forms of evidence (for example, statistical data and service user narratives) is critical for meaningful stakeholder engagement and public participation in drug policy, as well as effective policy design and implementation [30]. Stakeholder engagement could be achieved by following means:


5.Giving wide publicity to the final draft through print and electronic media by holding discussions on TV and Radio channels and generating further feedback for improvement of the draft policy before its finalization.

Only such a peer review process could lead to development of fool-proof, comprehensive, effective, inclusive, outcome-oriented, coherent, acceptable and well considered policy documents that shall in the long run prove to be successful in achieving the desired health-related goals and objectives. Broadly defined, a stakeholder is a person, group, or organization involved in or affected by a course of action. As per Lemke and Harris-Wai [31] stakeholder engagement refers to the process by which an organization involves people who may be affected by the decisions it makes or who can influence the implementation of decisions. Stakeholders may support or oppose decisions and may be influential in the organization or within the community in which they operate. Stakeholder engagement identifies areas of agreement as well as disagreement and provides an opportunity to understand more fully what might be driving key stakeholder differences. Stakeholder input may also help articulate the values of the broader community affected and align policy recommendations with these expectations [31].

Several different models describe a type of continuum, or different levels, of stakeholder involvement in decision making [32]. For example, the International Association of Public Participation's spectrum of participation defines five broad levels of increasing involvement in the engagement process: (i) inform (e.g., fact sheets, websites, open houses), (ii) consult (e.g., public comment, focus groups, surveys, public meetings), (iii) involve (e.g., workshops, deliberative polling), (iv) collaborate (e.g., citizen advisory committees, consensus building, participatory decision making), and (v) empower (e.g., citizen juries, delegated decisions) [33]. Although there is no perfect, one-size-fits-all model for developing policies or guidelines, defining stakeholder roles in any or all stages of genomics policy making is important to better evaluate and understand the policy-making process. A number of frameworks have been developed in various disciplines to assist policy makers in planning for policy development and analysis, and some include a specific component addressing key stakeholder consultation [34, 35].

Conklin et al. [36] have concluded from the results of a systematic scoping review that there is a need to build research capacity through incentives for more robust evaluations of public involvement in healthcare policy and to synthesize a better evidence base that consistently takes a common approach. In so doing, a greater step can be made towards a stronger evidence base for whether public involvement improves processes and/or outcomes of decision making and policy. Such evidence is a minimum requirement for comparatively assessing which areas of health-care policy are the most amenable to the use of public participation and then within a given area, what type of public involvement makes a difference in what context(s) [36]. In 2015 WHO published guidelines for developing country pharmaceutical pricing policies in which it was reiterated that "in establishing the legislative/administrative framework, countries should clearly define the roles and responsibilities of the decision-makers and other stakeholders, and the process of decision-making and the countries should ensure that health technology assessment processes are transparent and the assessment reports and decisions should be made publicly available and effectively disseminated to all stakeholders [37].

*Stakeholders in Pharmaceutical Policy Development DOI: http://dx.doi.org/10.5772/intechopen.105606*
