JOHANNESBURG, SOUTH AFRICA — At a global forum on fair pricing and access to medicines, delegates from governments and civil society organizations called for greater transparency around the cost of research and development and production of medicines to allow buyers to negotiate more affordable prices. 
 
The forum, co-hosted by the World Health Organization (WHO) and the Government of South Africa, aimed to provide a global platform for frank discussion among all stakeholders – including governments, civil society organizations and the pharmaceutical industry – 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 is a global one .  Each year, 100 million people fall into poverty because they have had to pay for medicines out-of-pocket. Hight -income countries health authorities are increasingly having to ration medicines for cancer, hepatitis C and rare diseases, For example,. the problem extends to older medicines whose patents have expired, like insulin  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.”
 
Evidence from a report commissioned by WHO in 2017 shows that the cost of production of most medicines on WHO’s Essential Medicines List represented a small fraction of the final price paid by governments, patients or insurance schemes.  Some delegates noted that because of a lack of transparency around prices paid by governments, many middle- and low-income countries pay higher prices for certain medicines than wealthier  countries. 
 
There was consensus that an initial step countries can take towards fostering greater transparency is to share price information. Some countries have already joined forces to share such information – such as the so-called Beneluxa network (Belgium, Netherlands, Luxembourg and Austria) –  with promising results. Information can highlight discrepancies between what different countries are paying and can be a powerful tool to negotiate reduced prices.  WHO’s data base on vaccine markets and shortages – MI4A – was also highlighted as a useful tool to reach competitive prices for vaccines.
 
The Forum highlighted other  successful examples of countries’ collaboration around achieving more affordable medicine prices, including 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.