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While it was
not the purpose of the workshop to seek agreed conclusions, there
seemed to be a large measure of common thinking among participants on
two central points:
- First,
that differential pricing could, and should, play an important
role in ensuring access to existing essential drugs at affordable
prices, especially in poor countries, while allowing the patent
system to continue to play its role of providing incentives for
research and development into new drugs.
- Second,
that while affordable prices are important, actually getting
drugs, whether patented or generic, to the people who need them in
poor countries will require a major financing effort, both to buy
the drugs and to reinforce health care supply systems, and that
for these countries most of the additional financing will have to
come from the international community.
The
workshop brought a better understanding of the subjects discussed,
bringing together for the first time all major interest groups
concerned with the financing and pricing of essential drugs. It was
intended to achieve a sharing of experience related to differential
pricing and financing of essential drugs while maintaining incentives
for pharmaceutical innovation. Not surprisingly, wide differences of
view were expressed by participants.
Nevertheless,
widely shared views on the need for enhanced financing and on the
feasibility of differential pricing were apparent at levels ranging
from abstract principle to operational detail. Many participants felt
that they had learned from the exchanges, and left with a broader
understanding of the issues involved in making further progress
towards affordable essential health care.
While
the workshop contributed importantly to a better understanding of a
number of key issues, many points were acknowledged to require further
in-depth analysis and discussion. These included:
- The
international funding required for ensuring effective access to
essential medicines in poor countries and the most appropriate
mechanisms for the mobilization and distribution of such funds.
- The
most appropriate ways in which differential pricing can be given
effect. Linked with this are questions of how the differential
price at which products will be sold in poor countries can be
determined, including how negotiation and competition should
contribute, in ways compatible with international agreements, to
achieving the most favourable prices, what constraints are imposed
by competition law, and how to develop incentives for differential
pricing.
- How
to insulate in political terms pricing in developed countries from
differential pricing in poor countries, including in regard to the
use of reference pricing systems? Also, the best ways of securing
effective separation of markets and preventing trade diversion,
while taking into account international trade rules.
- How
to treat middle-income developing countries and well-to-do
populations in poor countries under differential pricing.
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