OnCo
ideasIdea

Tie WHO essential-medicines listing to a published tiered price and supply pledge

When a cancer drug is added to the WHO essential medicines list, the maker should publicly commit to a low price and reliable supply for poorer countries, or the listing is withheld.

Listing on the WHO Model List of Essential Medicines is a reputational asset for manufacturers but carries no obligation. Many listed cancer medicines (trastuzumab, imatinib, rituximab) remained unaffordable or unavailable in most low-income countries for years after listing. The proposal is that the Expert Committee request, as part of the application, a public tiered-price schedule and a minimum supply commitment for low- and lower-middle-income countries, and publish which applicants declined.

Hypothesis
Within three years of a linkage policy, the median public-sector price of newly listed cancer medicines in low-income countries will fall by at least half relative to the pre-policy trajectory, and stock-out reports will decline.
Rationale
Naming-and-shaming works when the audience cares: the same companies publish access-to-medicine indices and lobby for EML listing. Vaccines show that price transparency plus volume commitments reshapes markets.
What would test it
Pilot with the next EML review cycle: require voluntary disclosure, publish who complied, and track price and availability through the WHO/Health Action International medicine price surveys.
Maturity
speculative
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
  • Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
  • Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.

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