Improving Market Transparency: Towards Affordable Healthcare

João L. Carapinha, Ph.D.


The 4th Fair Pricing Forum organized by the WHO is a major event that tackles the big issues in healthcare: how to make drugs and treatments affordable and accessible for everyone. In this update, we’d like to reflect on Parallel Session Number 1 that we recently attended on, “Improving Market Transparency of Health Products, Where to From Now,”. Following the 2019 adoption of resolution WHA72.8, countries have pursued greater transparency in health product markets. This session brought together experiences from Indonesia, Saudi Arabia, USA, and Slovenia working towards this goal, examining the successes, challenges, and impacts on product availability and affordability.

Does Transparency Affect Affordability?

Let’s get straight to the point: Does transparency really affect the affordability of medicines? This question kicks off our discussion, and it’s one that deserves a careful look. We’re dealing with a global healthcare scene where the cost and availability of drugs are complex.

Indonesia’s Approach to Improving Market Transparency

Take Indonesia, for example. They’re making strides toward creating an open competitive marketplace for medicines. By allowing healthcare facilities to negotiate directly with suppliers, they’re fostering competition. This decentralization means facilities can choose from various drug options, potentially leading to better prices and availability. It’s an innovative approach, encouraging suppliers to compete, which could lead to more affordable healthcare options for patients.

Strategies from Saudi Arabia and the United States

In the meeting, Saudi Arabia highlighted its strategic use of external reference pricing as a critical tool for negotiating drug prices, aiming to enhance market transparency and affordability. The country’s efforts also include engaging with pharmaceutical companies to ensure fair pricing and the utilization of updated price certificates to reflect net prices accurately. Meanwhile, the United States presented its novel approach through the introduction of Medicare’s drug price negotiation, marking a significant shift towards leveraging government efforts to influence drug prices. This initiative represents an attempt to address the longstanding issue of high drug costs in the U.S. by incorporating a more transparent and assertive pricing mechanism, which could potentially serve as a model for combining transparency with strategic negotiation to improve drug affordability.

European Perspectives and the EURIPID Database

Then, there’s the European scene, where the EURIPID database shines a spotlight on medicine prices. This database is becoming a critical tool, especially as it starts to include information on managed entry agreements. But here’s the kicker: How do we measure the performance of these agreements? It’s a pressing question because it directly impacts the effectiveness and value of the transparency efforts.

Lifecycle Perspective on Transparency

The notion that we need a lifecycle perspective on transparency and pricing options is gaining traction. It’s about understanding where a product is in its lifecycle. Are we dealing with cutting-edge innovations with no existing comparators, or are we talking about generic medicines? This distinction is crucial because it could lead to more nuanced and effective pricing strategies, ultimately benefiting patients.


So, when we circle back to our opening question about transparency’s impact on affordability, the answer isn’t black and white. Initiatives like Indonesia’s push for a competitive marketplace and Europe’s EURIPID database are steps in the right direction. They suggest that with the right approach, transparency could indeed lead to more affordable healthcare options. In summary, while the path to affordability through transparency is fraught with challenges, it’s clear that innovative approaches and a lifecycle perspective on pricing could pave the way for more accessible healthcare. The journey towards a transparent, fair, and affordable healthcare system is complex, but it’s one worth taking.