Final report released of WHO-WTO Secretariats’ workshop on drug pricing

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.