International drug pricing transparency resolution diluted

The World Health Organization's (WHO) member states recently adopted a watered down resolution on improving drug price transparency that leading medical charity Doctors Without Borders (also known by its French acronym MSF) criticised as insufficient.

An initial draft of the resolution first introduced by Italy at WHO's main annual meeting on May 20-28, 2019, called for near absolute transparency in the pharmaceutical sector, including requirements that companies make all data from clinical trials publicly available.

The Italian text presented to the World Health Assembly also demanded full disclosure from pharmaceutical firms on net revenue, once research and development, tax breaks and other subsidies are factored in.

Several countries – notably those that host large pharmaceutical industries like the United States, United Kingdom, Germany and Switzerland – expressed reservations about the Italian draft.

The final version includes several modifications.

For example, an earlier draft called on governments to "require the dissemination of results and costs from human subject clinical trials regardless of the outcome".

But the approved text urged states to "take the necessary steps, as appropriate" to make data from clinical trials public "regardless of outcomes or whether the results will support an application for marketing approval, while ensuring patient confidentiality".

The language was similarly softened with respect to the production costs incurred by drugmakers and patent notification.

Campaigners say some drugs are highly overpriced although they are often developed with public funding and that governments at times negotiate prices without any idea of how much the drugs cost.

MSF in a statement called the resolution "a welcome first step", but said it did not go far enough.

"While earlier drafts of the resolution included clear language to bring more transparency to this opaque area, unfortunately a small group of countries … obstructed more concrete advances," it added.

It singled out the UK, Germany, Japan and the US as countries that "chose to place the interests of a handful of corporations above the interests of people".

"We need to know the mark-ups corporations charge, production costs, the cost of clinical trials, how much investment is really covered by companies, and how much is underwritten by taxpayers and non-profit groups," MSF said.

The only way to guarantee fair drug pricing is to have fair negotiations, which "are impossible without transparency", it added.

WHO has for years supported calls for drug pricing transparency, arguing that a more open, balanced market would improve access to life-saving drugs, notably in lower income countries.