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World IP Day

What’s wrong with IP rights? Protecting medicines from competition can be costly

Gram for gram a HIV medicine costs more than gold.
What makes drugs so costly?
Is it research and development, or have the prices of essential, life-saving drugs been ramped up by a lack of transparency and abuse of a system intended to reward innovation?

Estimated read: 7 minutes

26 April 2019 is World Intellectual Property Day. Intellectual Property. IP. Must be important, to have its own day? So, what do you know about it?

It’s something to do with rights, right? Along the lines of if you invent something, something that you’ve invested time, money and more than a sprinkling of ‘genius’ in, then you can patent your invention for 20 years. That ensures that someone else can’t just come along, copy your idea and make a quick million bucks off the back of your hard work. Sounds fair enough?

A lot of people think of an inventor in a shed, or state-of-the-art tech when you say ‘IP’. But what about when it’s medicines being patented? You can choose whether or not to buy a swanky new gadget, but you don’t choose to get sick, and you don’t choose to need a medicine that gram for gram costs more than gold.

That’s why some people think medicines shouldn’t be owed by anyone, that they are for the good of the people and shouldn’t be monetised at all. Like Jonas Salk, inventor of the polio vaccine, who when asked ‘who owns the patent?’, famously said: “The people, I would say. There is no patent. Could you patent the sun?”

On the other hand, many would argue, discovering new medicines takes time. Lots of it, decades of development and testing, depending on which accounts you read. Plus, after rigorous testing for efficacy and safety, the majority of drugs don’t make it to market (unless you lie about it of course), and who’s supposed to foot the bill for that?

If (and we’ll come back to this word shortly) companies, rather than governments, invest all this time and skill, then there’s got to be an incentive, right? After all, pharmaceutical companies aren’t in it simply for the good of their health, they are a profit-making industry and don’t feign otherwise.

The flow of invest-reward-invest-reward is supposedly what keeps the cogs turning; new medicines being invented; sick people made better.

Then why do pharmaceutical companies seem to get so much flack these days? After all, it sounds like they are just protecting their hard work. Why do treatment activists and pharmaceutical companies who, on the face of it, should be on the same side, have such a bad reaction towards each other? Let’s examine the hotly contested research and development (R&D) argument.

‘Monopolies are necessary in order to recoup the investment and put more money into developing new drugs.’  This, or phrases along these lines, are Big Pharma’s favourite tropes. The industry has repeated this for years. But is it true?

Let’s break it down. To assess the argument’s merit we need to discover who invests in R&D, whether the amount being recouped is fair, and whether that actually leads to more innovation.

R&D: It’s NOT a solo venture

Billions go into biomedical research and development every year. Each year it fluctuates from country to country, and it is generally a combination of public money and industry investment. 

The current trend is for the majority of investment to come from industry. It’s to be expected, as the whole point of the present system is for those that invest to get a return. No-one’s begrudging a fair profit, after all that was the idea: invest-reward-invest-reward. 

The pharmaceutical industry is the third most profitable in the world, so there are pretty healthy returns, and it’s a strong indicator that profits have gone way beyond a point of merely recouping costs.

The pharmaceutical industry is the third most profitable in the world.

Add to that that not all investment comes from industry, it varies from country to country, but a decent percentage comes from government. Take the USA as an example, in 2017 67% of medical investment came from industry, but 22%, not an insignificant proportion, was funded by the government. 

Presumably that would mean that around 1 in 4 medical patents in the USA are owned by the government, and can be priced fairly for the good of citizens, based on the proportion of investment. They don’t. So where is that return on the government’s investment going?

Who’s paying for patents?

Only last month, a Washington Post headline ran: An HIV treatment cost taxpayers millions. The government patented it. But a pharma giant is making billions.

The drug is Truvada for PrEP, the company is Gilead.

The New York Times also ran a piece on the same example. In it the columnists, co-founders of PrEP4All, explain how the price for generic Truvada costs less than $6 per month in other countries, “but Gilead charges Americans, on average, more than $1,600, a markup from the generic of 25,000 percent.”

It continues: “Infuriatingly, American taxpayers and private charities — not Gilead — paid for almost all of the clinical research used to develop Truvada as PrEP.” 

This is not uncommon. Often drugs initially developed in the public sector are bought, not invented, by pharma companies, which then complete the development and file the patent.

In this case surely the argument, that such high prices are necessary to recoup costs from years of investment, has to be thrown out of the window. 

Gilead has earned $36.2 billion on Truvada since 2004 according to its annual reports. The total funding needed to get the HIV response back on track has been estimated at $26 billion annually.

Why is the USA government paying for a drug that it largely funded, and allowing an unfair profit to be made by a private company when there’s a shortfall in HIV funding?

Treatment activists have been wondering whether it’s the “cosy relationship” between government and Gilead that prevents the government taking a stand on a patent that by rights shouldn’t belong to a pharmaceutical company. 

Not only is the pharmaceutical industry is the world’s third most profitable industry, it’s also THE largest lobbying power in the USA.

Why is the USA government paying for a drug that it largely funded when there’s a shortfall in HIV funding? And why the need for such heavyweight lobbying?

Say Truvada for PrEP was the exception and not the norm. If the system was fair and therefore it was patently obvious that countries must pay for the price of investment, then why the need for such heavyweight lobbying?

Industry’s influence on, or in, government 

As THE largest lobbying power in the USA, pharmaceutical companies effectively have a seat at the government’s table, and not just figuratively speaking.

Pharmaceutical companies have a seat at the USA Government’s table, and not just figuratively.

Alex Azar is a lawyer, pharmaceutical lobbyist and former drug company executive. He’s also the current Secretary of Health and Human Services. Let’s repeat that. A pharmaceutical lobbyist holds the USA’s most senior health role.

In ‘NO is not enough’ Naomi Klein describes what’s happening in Washington since Trump’s election as a “naked corporate takeover”. Klein writes: “Apparently, all that wining and dining of elected officials, all that cajoling and legalised bribery, insulted their sense of divine entitlement. So now they’re cutting out the middlemen – those needy politicians who are supposed to protect the public interest – and doing what top dogs do when they want something done right: they are doing it for themselves.”

Who else who sits on Trump’s cabinet? Sitting alongside Azar is a millionaire investor who lied about his net worth. He’s the Secretary of Commerce. An investment banker and previous hedge fund manager is Secretary of the Treasury. Exxon-Mobile, General Dynamics, Boeing, and Goldman Sachs alumni and board members have also sat round the table in Washington in official roles. This shows that Azar is not the only one holding a position with a glaring conflict of interest. “Trump’s cabinet of billionaires and multimillionaires tells us a great deal about the administration’s underlying goals,” writes Klein.

When you think of it it beggars belief, you couldn’t make it up, and yet it’s true. How about numbers though, can you make those up?

How much does drug development cost?

Unfortunately the one thing numbers can’t add up to is agreement.

Estimates for the cost of a medicine, “from invention to pharmacy shelves” varies from $30.3 million to $2.7 billion. This guys argues, in Forbes, that it’s the upper limit. In his words: “What really drives up costs is the fact that 90% of medicines that start being tested in people don’t reach the market because they are unsafe or ineffective. The $2.7 billion figure includes the cost not only of these failures, but also of not putting the money spent on them into something that would give a more reliable return.”

The high-end figures come from industry-funded studies, and as an MSF report states, they chose to include “arbitrarily inflated” costs yet don’t account for the public support.

Big Pharma is notoriously un-transparent about R&D costs. While that remains the case we’ll never know the true costs, but even if you take the low end of the calculations it begs the question, ‘how much profit is enough?’.

How much profit is enough? Blockbuster Drugs

Take a ‘Blockbuster Drug’, two words that, for many, sit together uncomfortably. The pharmaceutical industry defines a blockbuster drug as one that meets the “$1 billion USD annualsales milestone”.

Let’s do a quick calculation: $1 billion per year (minimum) x 20 years standard monopoly = $20 billion (minimum). 

That was easy. However, it might take a blockbuster drug up to four years to reach its potential. Let’s knock off $4 billion – of course they don’t earn nothing in the first four years, but just for ease, plus let’s also minus the top-level, industry-funded estimate ($2.7 billion) that a company invested.

That’s now ‘dwindled’ down to $13.3 billion. Of course, not every drug is grossing $13 billion plus, but we also know not every, if any, drug costs $2.7 billion to create either. To provide some context, Avatar is the most expensive movie ever made. The costs were over $478 million and it grossed over $3 billion worldwide. At least $10billion less than a blockbuster drug.

The most expensive movie ever made grossed $10 billion less than a ‘Blockbuster Drug’.

A less dramatic way to look at it would be to take each drug on the World Health Organization’s (WHO) list of essential medicines and compare the cost and price of all the drugs on it. That’s what researchers at the University of Liverpool did. The research looked at cost of production, which included manufacturing, formulation, packaging, taxation and a 10% profit margin. It found a significant gap between the cost and price of the majority of medicines on the list.

Still though: Innovation, innovation, innovation

So prices for patented medicines are excessive. However, perhaps even for those uncomfortable with such steep profits being attached to medicines, maybe the incentive of earning billions is OK if it achieves an end goal of discovering more effective drugs, and more breakthroughs and cures?

After all, once the 20 year patent period has expired we should expect that competition gets introduced, prices drop massively, and pharma companies race to find new, effective (and profitable) drugs.

But wait. A patent doesn’t always end after 20 years. There’s a common practice called evergreening. This is when companies effectively extend their monopolies by applying for multiple, overlapping patents, with small changes, on the same drug.

A monopoly often doesn’t end after 20 years.

Take Thailand. During an 11 year period (1999-2010) 82% of patent applications were examples of evergreening, and 72% of patents granted also fell into that category. In one example there were six patents and a total monopoly period of 31 years on one drug.

Even in cases of genuine innovation, it means nothing if you, or your government, can’t afford the drug that’s needed to save your life15.2 million of the 36.9 million people living with HIV do not have access to treatment.

Investing in drugs, or patents?

Instead of incentivising innovation, the practice of evergreening patents actually stifles innovation, leading to less medical breakthroughs. If you can continue to make millions or billions on an existing product it removes much of the profit motivation to develop new products. 

Paediatric drugs have particularly suffered due to this practice, due to a ‘limited market’. It seems that sick children just aren’t profitable enough. 

“We are not markets, we are people” – Lorena Di Giano, Executive Director, Fundación GEP.

A country can refuse to grant an unmerited patent, including evergreening patents, while an application is pending, or, when a patent is granted issue what’s called a compulsory license, which effectively overrides the monopoly if there is a public health need. The classic case for the latter is when a government can’t afford to treat all people in need at the prices charged, and to prevent or tackle a public health crisis, it uses its legitimate right to source more affordable, trusted, generic versions.

This is all laid out in a multilateral agreement know as TRIPS (Trade Related Aspects of Intellectual Property Rights Agreeement) and the Doha Declaration (Declaration on the TRIPS agreement and public health. The problem is that often when governments legitimately push back pharmaceutical companies use their legal and financial muscle to push back harder. 

Examples of how that ‘push back’ has manifested in the past include threatening an impact on trade, or refusing to register new drugs in a country. One reason countries may decide not use the ‘flexibilities’ entitled to them under the TRIPS Agreement is the fear of these types of consequences. Another theory as to why these rights aren’t enacted in the first place is because if industry is within governments or at least influencing them, then governments are less likely to act, as they’d effectively be pushing back against their own interests.

The current system, connected to the enigma of R&D costs, keeps prices and profits unfairly high, and there’s little or no recourse. One proposed solution is de-linkage. The argument is that R&D funding should not be tied to the price of the product. Monopolies and high prices would be replaced with alternative incentives based upon cash rewards, and expanded funding for research, drug development, and clinical trials through a combination of grants, contracts, tax credits, and other subsidies.

The R&D argument is unmerited

The current system, and the arguments made by pharma that prop it up, amounts to a lot of profit but not much else.

There are many more examples of IP abuse that can be cited here, and so for an industry built on medicines, there’s an unhealthy amount of controversy.

If you wnat more convincing, consider these salaries: Among the recent top 10 highest paid pharma bosses was the Gilead CEO taking home $13.9 million a year; the AbbVie chief exec securing a $18.8 million salary (that’s the company that pulled all new drugs when a country enacted its rights), and the Bayer boss earning $25.27 million.

That’s per year, just take that in. In just one year, 110,000 children died of HIV-related illnesses$25 million, ONE person’s salary, could be enough to provide 416,000 children with life-saving HIV treatment for a year. Now that’s got to make you sick.

read more at : http://makemedicinesaffordable.org/en/whats-wrong-with-ip-rights-protecting-medicines-from-competition-can-be-costly/?fbclid=IwAR2HJTweUSAGILrpJFiy73SDq_AXxB2jlmPkIfLtKHp1x13fD85IcR0uRbM

Strong call for transparency on medicine prices, cost of R&D at WHO Fair Pricing Forum

“Medical innovation has little social value if most people cannot access its benefits…. this is a global human rights issue,” said Mariângela Simão, Assistant Director General at the World Health Organization (WHO), at the opening of the second WHO Fair Pricing Forum, co-hosted by South Africa, which took place 11-13 April 2019 in Johannesburg, South Africa.

The Forum brought together over 200 delegates from government, NGOs, academia and industry to discuss how to design a fairer pharmaceutical system where medicines are affordable to those in need and the development of effective new treatments is financed appropriately. Medicines Law & Policy was invited to present the TRIPS Flexibilities Database at the Forum; this database lists instances of the use of provisions in patent law to reduce prices on needed medicines, shedding light on how often they have been needed.

Calls for drug price and cost transparency grew louder at the second Forum, though they began at the first Fair Pricing Forum held in the Netherlands in 2017. High prices are defended by pharmaceutical companies as necessary to recoup costs of research and development (R&D) and incentivise further research, but with little clarity on how much R&D truly costs nor how medicines prices are set it is difficult to objectively determine what price is fair. Cases of exponential increases in the price of previously affordable drugs when market exclusivity was obtained were cited as examples that current prices seem to be more about profit than recouping costs.

Cancer took centre stage

The cost of cancer treatment took centre stage at the Forum, with the WHO’s report on the pricing of cancer medicines providing important background.  The study found that the costs of R&D and production may bear little or no relationship to how pharmaceutical companies set prices of cancer medicines. Return on investment is more than generous with an average income of US$ 14.50 for every R&D dollar spent.

Cancer patients from South Africa gave powerful testimony at the Forum (and outside where activists were demonstrating and addressing the media) of the hardship caused by the high cost of the treatments.

One patient, who asked to remain anonymous, described his quest to gain access to the treatments he needs. Three years ago, he was diagnosed with multiple myeloma. His doctor prescribed lenalidomide, a derivative of thalidomide, which is sold under the brand name Revlimid by Celgene. In India, generic lenalidomide is available for R32,000 (US$ 2289) per patient per year. Until 2016, South African patients had access to generic lenalidomide from India under a section 21 authorisation that allows the sale and use of unregistered products. This authorisation was withdrawn once Celgene registered the product in the country. Celgene priced it at R882,000 (US$ 63,000) per patient per year. While the health system provides the drug, patients are struggling to pay the 20% co-payment. South Africa’s GDP per capita is US$ 6,160. According to the Cancer Alliance, South African patents block access to generic lenalidomide and this may last until 2028. Celgene told its shareholders earlier this year that it expects sales of Revlimid to be around US$ 10.8 billion in 2019. Bristol-Myers Squibb is currently in the process of taking over Celgene for US$ 74 billion.

There are similar issues with other cancer medicines. Trastuzumab (Herceptin), a WHO essential medicine for the treatment of HER2 positive breast cancer, costs R130,632 (US$ 9,295) in the public sector and R475,380 (US$ 33,827) in the private sector in South Africa. Biosimilar versions of trastuzumab are beginning to become available elsewhere in the world because the basic patent expired in 2016. But not in South Africa, where the company Roche continues to benefit from a market monopoly. The production cost of this same treatment is around US$ 240 for a one-year supply. Roche’s annual sales for the product is around US$ 7.5 billion.

Pembrolizumab (Keytruda) is a second-line treatment of non-small cell lung cancer and is priced at R180,000 (US$ 43,000). The Forum was told that to treat all in need would cost the South African health system R200 million (US$ 48 million).

These stories helped to set the scene and impress on participants to the Forum that there is no fairness in the system and that finding solutions to the problem of high drug pricing is urgent. Just as it was 20 years ago for HIV.

Pharma vs Nelson Mandela

In the past, South Africa has been the scene of some of the fiercest battles for access to medicines. Director General for Health, Precious Matsoso, recalled some of the histories at the opening ceremony.  In 1998, at the height of the HIV crisis, 39 mostly multinational drug companies took the South African government to court over new provisions in its medicines law designed to accelerate access to lower-priced medicines. The companies claimed that the provisions were unconstitutional and in conflict with South Africa’s obligations under the TRIPS Agreement. Three years later, in 2001, the companies dropped the case after a global outcry and after it became clear that the legal text in question was based on draft legislation provided by the World Intellectual Property Organization (WIPO).

By then the case had become widely known as Pharma vs. Nelson Mandela and spurred global action on access to HIV medicines, strengthened flexibilities in patent law and made an industry in need of atonement agree to lower prices and later to offer patent licences to ensure low priced generic HIV medicines could be made available.

Twenty years ago, access to medicines was predominantly a problem for developing countries. “Today access to medicines has become a global issue”, said Simão.

Drug pricing a global issue

In Switzerland, the civil society organisation Public Eye requested the government for a compulsory licenceon the patents related to the breast cancer medicine pertuzumab, sold by Roche under the brand name Perjeta. The US$ 100,000 price tag of Perjeta in Switzerland underscored the point that medicines pricing is a global issue. Similar demands have been made in other countries. Wilbert Bannenberg, chair of the Dutch Pharmaceutical Accountability Foundation described the case of a rare disease medicine, CDCA, used for the treatment of the metabolic illness cerebrotendinous xanthomatosis (CTX). For years, the product was available for € 300 per patient per year and prescribed off-label to treat CTX. After the drug company, Leadiant was granted exclusive rights to market the product in Europe for CTX in 2017, it increased the price to € 153,300 per treatment-year. Bannenberg’s presentation emphasised the need for competition authorities to take action against excessive drug prices. He further outlined his organisation’s plans to use the law (competition law, patent law, human rights law, civil law) to challenge unfair medicines pricing.

It may have been coincidence that shortly after the start of the Fair Pricing Forum, the Dutch Minister of Health Bruno Bruins announced his plans to reduce the exclusivity for orphan drugs from 10 to 5 years in the EUropean Union (EU) and to establish a commission to study the use of compulsory licensing to gain access to lower priced medicines in the Netherlands. A review of the pharmaceutical incentives in the EU is underway. Bruins also decried the lack of transparency in drug pricing and cost of R&D.

Dr Salmah Bahri, director of pharmaceutical services at the Malaysian ministry of health, described her country’s comprehensive approach to selecting and financing access to essential medicines. Malaysia does not shy away from using compulsory licensing when needed and has reduced the cost of hepatitis C treatments from US$ 72,000 to less than US$ 300 in the public sector by allowing generic import and supply of the product. They are also working with the Drugs for Neglected Diseases initiative (DNDi) on the development of a low-cost hepatitis C treatment.

Gaëlle Krikorian, from Médecins Sans Frontières (MSF), told the meeting about vaccine pricing challenges the organization deals with. MSF’s Access Campaign succeeded in persuading Pfizer and GlaxoSmithKline to significantly drop the price of the pneumococcal conjugate vaccine (PCV) for humanitarian organizations. Organisations working in emergency settings can now obtain the vaccine for US$ 9 per child under the ‘humanitarian mechanism’. It took seven years of negotiation to obtain the lower price. While this is good news for children in crisis settings others cannot benefit from this price. The list price of the vaccine is US$ 540 per child. In reality, prices vary but are high: France pays US$ 189, Lebanon US$ 243 and the price in local Greek pharmacies is US$168. MSF recently announced that it will use the “humanitarian mechanism’ to protect refugee children in Greece against pneumonia, the world’s ‘number one childhood killer’ according to MSF. Since 2009, Pfizer and GSK have earned $49.1 billion in sales from the pneumonia vaccine, said MSF.

Othman Mellouk from the International Treatment Preparedness Coalition (ITPC) also drew attention to the plight of people in middle-income countries. He mentioned the case of dolutegravir, an essential medicine for the treatment of HIV which will be available for US$ 75 per patient per year in low and middle-income countries.  The patent license agreement reached by the Medicines Patent Pool with ViiV and the price deal brokered by the Clinton Health Access Initiative and partners exclude 39 countries,  mostly upper middle-income countries. The World Bank defines lower middle-income economies as those with a GNI per capita between $1,006 and $3,955 and upper middle-income countries as those with a GNI per capita between US$3,956 and US$12,235. Above this figure, the country is considered high-income.

Transparency, transparency, transparency

The call for transparency emerged as the central theme of the meeting, in particular with regard to medicines pricing, production cost and expenditures on R&D. 64 civil society organisations published a statement before the meeting calling for greater medicines pricing and R&D cost transparency.

Andrew Hill presented data on the production cost of essential medicines that demonstrated most of them could be produced for a fraction of their current prices. For example, the price based on production cost for the US$ 30,000 per patient per year cancer drug imatinib can be as low as US$ 180 per patient per year. Insulin, which was discovered in 1923, cost US$ 1 per vial to make but is sold at US$ 240 per vial today. The global insulin market is valued at US$ 28 billion. Greater price transparency will help countries to understand the savings they can make by buying generics. The same call could be heard earlier this year at the Executive Board of the WHO. Since then, Italy has proposed a World Health Assembly resolution to improve the transparency of markets for drugs, vaccines and other health-related technologies. The resolution is expected to be discussed at the 72nd World Health Assembly that takes place from 20 – 28 May 2019.

The need for greater transparency in R&D cost was brought forward by the first Fair Pricing Forum, including the potential it has for designing targeted rewards for needed innovation.

Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) fiercely resisted the calls for transparency on medicines pricing. He warned greater transparency on medicine prices could backfire, and drive up drug costs in low and middle-income countries. This could, for example, be the case if high-income countries would refer to low prices available in low-income countries and demand the same lower prices or use it for reference pricing. Meeting participants seemed to agree with making provisions needed to allow for significant differential pricing. However, Suerie Moon from the Graduate Institute in Geneva pointed out that this would require more reasonable pricing in high-income countries as well. A fair price, she explained, is one that covers the cost made by the seller (including R&D, manufacturing and distribution, and fair profit) and assures affordability, value to the individual and the health system and security of supply to the buyers.

Jamie Love, director of Knowledge Ecology International, warned against using patient coverage as leverage in price negotiations. “Put the compulsory licensing of patents on the table, so that the monopoly is at risk, rather than the patient,” he said. He further outlined a proposal to finance the cost of R&D in a different manner.  “Temporary monopoly is the primary incentive today, enforced by patents and a variety of regulatory monopolies. This is expensive and the primary reason why prices are high and access unequal,” Love said. By implementing models that de-link the cost of R&D from the price of medical products to finance drug development, high prices are no longer required to recoup R&D expenditures. He mentioned market entry awards and product prizes as two possible such models. He proposed a progressive implementation of de-linkage awards to gradually replace market exclusivities. A next step should be a feasibility study of the proposed new models. Such exploratory work would also benefit from greater transparency.

One successful example of an innovation initiative that works with a delinked model is the Drugs for Neglected Diseases Initiative (DNDi). The DNDi is open about its R&D outlays. “We need to be publicly accountable and be able to show the public’s return on the public investments we use to develop new treatment’ said Michelle Childs, head of policy advocacy at the DNDi.

The Medicines Patent Pool is another example of an organisation committed to transparency. The MPP publishes all its agreements in full on its website. The MPP initially focussed on HIV and later hepatitis C, but has expanded its mandate to negotiate licenses for all patented essential medicines. One company, with a significant cancer portfolio that was present at the Forum indicated that it is in talks with the MPP.

At the closing of the meeting, Fatima Suleman, a professor in pharmaceutical sciences at the University of KwaZulu-Natal and chair of the National Medicines Pricing Committee, noted the striking increase in research, available data and analysis to inform better policy making on medicines pricing and cost. Indeed, telling examples presented at the meeting included the WHO report on cancer drug pricing, the research on production cost of essential medicines by Andrew Hill, analysis on how to determine a fair medicine price and work on transparency by Suerie Moon, the TRIPS Flexibilities Database by Medicines Law & Policythe patent opposition database,  medicines patent analysis by I-Mak, the patent status information databases Medspal by the Medicines Patent Pool and Patinformed maintained by WIPO in collaboration with the IFPMA, and the drug research, development and pricing information database by Knowledge Ecology International.

What next?

The WHO announced it would set up working groups to further develop proposals put forward at the meeting before the next Fair Pricing Forum takes place in 2021. WHO will also launch an online public consultation in the coming weeks to collect suggestions for a definition of what constitutes a ‘fair price’. The next milestone will be the discussions on price and R&D cost transparency at the World Health Assembly this May of year.

The presentations made at the meeting will be available at the Fair Pricing Forum website.

Read more at : https://medicineslawandpolicy.org/2019/04/strong-call-for-transparency-on-medicine-prices-cost-of-rd-at-who-fair-pricing-forum/?fbclid=IwAR3yzXxMJ6efmTaCvUvmxXxZpuuTWa2yp7qPvNCfIVvVIFAV5yeJcPnfIbk