US citizens pay about six times what Europeans do for insulin, the cost of which has almost tripled over a decade in that country, according to the American Diabetes Association.
How pharmaceutical companies set the prices of their medicines is surrounded in secrecy, but their general approach seems to be to make them as high as the various markets allow. As with the first Fair Price Forum two years ago in Amsterdam, the Johannesburg participants – from governments, civil society and the pharmaceutical industry – grappled with this lack of transparency, as well as the price negotiations countries engage in with pharmaceutical companies, which are often smothered by confidentiality clauses.
Eighteen years ago, members of the World Trade Organisation adopted the Doha Declaration, which clarified that the Trips agreement allows member states to “take measures to protect public health”, including the right to issue compulsory licences to third parties to make medicines without the consent of the patent holders where warranted – such as during health emergencies.
The excuse of the high cost of research and development – R&D in pharma lingo – of new medicines was exposed in 2018 in a WHO report on cancer medicine pricing. The report found that, by 2017, the 99 cancer drugs approved by the US Food and Drug Administration had each made an average “return” of $14.50 for every $1 of R&D money spent.
Pillay also travelled to India and met with generic medicine manufacturers to encourage them to tender to supply the ARVs and, since 2010, those supplying the country’s ARVs have been a mix of local and international companies, as well as generic and patented medicine.
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