At a global forum on fair pricing and access to medicines
held in Johannesburg last week, delegates from governments and civil society
organisations have called for greater transparency around the cost of research
and development as well as production of medicines, to allow buyers to
negotiate more affordable prices. 

The three-day Fair Pricing Forum, co-hosted by the World Health
Organization (WHO) and the South African government, aimed to provide a global
platform for frank discussion among all stakeholders – including governments,
civil society organisations and the pharmaceutical industry in order to
identify strategies to reduce medicine prices and expand access for all.

The affordability of medicines has long been a concern for
developing countries, but today it is also a global one. Each year, 100 million
people fall into poverty because they have to pay for medicines out-of-pocket.
High-income countries’ health authorities are increasingly having to ration
medicines for cancer, hepatitis C and rare diseases. The problem extends
to older medicines whose patents have expired, such as insulin for diabetes.

“Medical innovation has little social value if most people
cannot access its benefits,” said Dr Mariângela Simão, WHO Assistant Director
General for Medicines and Health Products.  “This is a global human rights
issue – everyone has a right to access quality healthcare.”

A report commissioned by WHO in 2017 showed that
the cost of production of most medicines on WHO’s Essential Medicines List was
a small fraction of the final price paid by governments, patients or insurance
schemes. Some delegates at the forum noted that a lack of transparency around
prices paid by governments means that many low- and middle-income countries pay
higher prices for certain medicines than wealthier countries do.

There was consensus that countries can take an initial step
towards fostering greater transparency by sharing price information. Countries
from the so-called Beneluxa network have already joined forces to share such
information, and the results have been promising. The data highlights
discrepancies in what different countries are paying and can serve as a
powerful tool to negotiate reduced prices. WHO’s database on vaccine
markets and shortages was also highlighted at the forum as a useful tool to
achieve competitive vaccine prices.

The event highlighted other successful examples of
countries’ collaboration around achieving more affordable medicine prices;
these include pooled procurement and voluntary sharing of policies. If several
countries in the same region purchase medicines as a block, they can negotiate
reduced prices due to the larger volume of medicines purchased.  And
European countries led by Austria have been sharing different policies to
expand access to medicines through the WHO-supported PPRI (Pharmaceutical
Pricing and Reimbursement Policies).

Industry bodies at the forum expressed support for the goal
of access to medicines for all, and expressed their commitment to the
Sustainable Development Agenda, which calls for partnership with the private
sector to address global challenges such as access to medicines.

WHO will launch a public online consultation in the coming
weeks to collect views and suggestions for a definition of what actually
constitutes a ‘fair price’ from relevant stakeholders.

Source: WHO