[Ip-health] Stat+: Why the Italian health minister is pushing for global transparency on drug pricing
thiru at keionline.org
Tue Mar 12 12:05:29 PDT 2019
Why the Italian health minister is pushing for global transparency on drug
By ED SILVERMAN @Pharmalot
MARCH 12, 2019
Last month, the Italian government asked the World Health Assembly to adopt
a resolution to require drug makers to disclose their R&D and production
costs, as well as prices charged for medicines and vaccines. Italian health
minister Giulia Grillo wrote to the World Health Organization that
“international action is required to improve transparency” in order to
widen access to pharmaceuticals. If the resolution is enacted, the WHO
would have a mandate to collect and analyze data on clinical trial
outcomes, assess patents, and provide a forum for countries to share
information on prices, R&D and marketing costs, R&D subsidies, and public
sector investments. In effect, the proposal would set an international
standard, but is likely to get pushback from the pharmaceutical industry.
We spoke with Grillo, who publicly announced the move on Tuesday, about the
effort. Her comments are from both an email exchange and a phone
conversation. This interview has been lightly edited.
Pharmalot: What will transparency accomplish?
Grillo: Today’s world is moving extremely fast and we cannot — and must not
— use outdated models to face the changes of our society. Transparency is
one of the highest concerns to the public in that it allows everyone to
feel part of the political process. The resolution goes in a simple
direction: Increasing the exchange of information can only bring benefits
to patients, wherever they live. Transparency aims to protect the rights of
citizens and to promote participation, widespread forms of control over the
activities of the institutions and the use of public resources.
Bringing the theme of transparency to an important forum such as the WHA
represents a challenge as well as the achievement of a cultural goal. More
concretely, price transparency is one of the key criteria to securing
healthy pharmaceutical markets, which in turn is an essential prerequisite
to guarantee access to the population in need of medicinal treatment.
The multinational (pharmaceutical) companies operate locally, but have a
global vision of their market. As individual buyers, we are just a fragment
of an overarching situation over which we have no control. So what we need
is to create a functional alliance to become competitive in terms of being
able to apply greater negotiating power when it comes to having a
relationship with these multinationals.
Pharmalot: Why do you think the WHA might adopt the resolution?
Grillo: Because ethics is not an abstract term. Ethics and social
responsibility — in the economic, financial, and cultural fields — must be
the guiding principles in political action. Transparency is the tool for
achieving this objective. We think that this resolution should be adopted
to disseminate a message of change. Our aim is full access to price
information about medicinal treatment because we are sure that it can be a
new democracy step.
European governments are evaluating the current set of incentives provided
to industries which develop medicines in order to understand the
cost-effectiveness of the current incentives, to assess their impact on
access and affordability, and to consider new approaches decoupling the
incentives from high prices or temporary monopolies.
Pharmalot: There is a WHA meeting in May. How soon do you expect the WHA to
Grillo: We expect it will be discussed. I don’t know how long it will take,
but what I can tell you is our goal is to see something by the end of 2019,
at least to see an international framework or timing in order to increase
transparency on the cost of medicines.
Pharmalot: What kind of support have you received?
Grillo: We have received expressions of support from Greece, Spain, Mexico,
the Netherlands, Portugal, Chile, South Korea, and Malaysia. We need to do
more, but this is just the beginning. We haven’t had that much time. Only
one month has elapsed (since we sent the resolution). I can tell you we’re
going to take many more contacts.
Pharmalot: And what kind of pushback do you expect from the pharmaceutical
Grillo: I already know that the pharmaceutical companies are going to be
extremely critical. More transparency is going against their interests. On
the other hand, there are 194 countries that buy medicines and need to gain
more bargaining power vis-a-vis the pharmaceutical industry. We need to
score some points on the side of the patient. This is not going to be a
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