Medicines: Fair pricing forum

For the purposes of this initiative a ‘fair’ price is one that is affordable for health systems and patients and that at the same time provides sufficient market incentive for industry to invest in innovation and the production of medicines. In other words, fairness here implies positive incentives and/or benefits for all stakeholders – i.e. those who purchase and use medicines, and those involved in the R&D and manufacture of medicines.

Absolutely not. The Fair Pricing Forum strives to increase access through better affordability. It focuses on new, high-priced medicines and vaccines that are currently unaffordable in most countries – regardless of income. But it also looks at old medicines whose prices have been so reduced that they no longer present any kind of incentive for manufacturers. The principle of affordability and access to quality medicines guides the fair pricing initiative and remains a stalwart of WHO’s work on access to medical products.

The Forum is taking place in Johannesburg, South Africa, on 11-13 April 2019 and is co-sponsored by the South African National Department of Health and WHO.

Fair pricing is a WHO initiative supported by many governments, including the Government of South Africa through its Minister of Health, who will be hosting the forum along with the WHO Director-General.

The ‘Fair Pricing Forum’ aims to provide a global platform to discuss ways to improve access to medicines – including high-priced ones – within the overall effort of supporting countries to develop effective access strategies to achieve universal health coverage. At the same time, it also intends to understand the input needed by the pharmaceutical industry to improve R&D and innovation from a public health perspective and to keep old and generic essential medicines on the market.

Participants include WHO Member State Governments, patient associations, civil society, insurers and the pharmaceutical industry.

The intention behind the fair pricing initiative is closely linked to WHO’s broader agenda for supporting access to medicines, improving public health across all regions and promoting universal health coverage. In addition, WHO Member States have formally requested that WHO’s Director General, through World Health Assembly Resolution WHA67.22 (Access to essential medicines, 2014), support countries to “ensure access to safe, effective and quality-assured essential medicines, including high price essential medicines.”

The current status of medicines prices is fast becoming one of the biggest challenges to health systems everywhere and is the subject of countless debates in parliaments and in both medical and mainstream media. The time is ripe for greater involvement of the global health community to discuss this issue and seek realistic solutions for greater affordability. The main barrier to accessing many new and effective medicines, especially for cancer and orphan drugs, and more recently for hepatitis C, is their lack of affordability, even when there is evidence to show that manufacturing them is relatively inexpensive. This problem is now touching not only low-income countries, it is affecting middle- and high-income countries as well.

At the other end of the spectrum is the problem of drug shortages or poor quality for some old and off-patent medicines. There are a number of examples, ranging from benzathine penicillin to methotrexate, where there are significant problems with lack of manufacturers. For these products, it is necessary to work out what a ‘fair’ price would be that ensures quality products and ongoing supply.

WHO has both the mandate and the responsibility to address barriers to accessing health products and services that are vital to improving public health. As the global health coordinator within the UN system, WHO provides a unique global platform to discuss policy options for increased access to medicines through its convening power with all public health actors, both national and international.

In the lead-up to the forum, WHO will publish reports and landscape analyses related to pricing and the cost of R&D and production of medicines and other health technologies. It is hoped that a comprehensive report on pricing will be ready for launch at the May forum.

Fair pricing focuses on specific issues related to pricing (high and low prices) that constitute access barriers in an attempt to find strategies for countries to address these barriers in the near future. We believe that this initiative will contribute to the goals of the Global Strategy and Plan of action on Public Health, Innovation and Intellectual Property (GSPOA), the Consultative Expert Working Group on Research and Development (CEWG) and the UN High Level Panel on Access to Medicines. The initiative does not replace WHO’s ongoing work on intellectual property and TRIPS flexibilities.