ideasIdea
An international registry of real (net) cancer drug prices paid by public payers
Countries negotiate secret discounts, so nobody knows what anyone actually pays for a cancer drug. Sharing real prices between public buyers would strengthen every negotiation.
Confidential rebates mean list prices are fiction and payers negotiate blind, a situation that the WHO Fair Pricing Forum and the Oslo Medicines Initiative have identified as a major driver of high prices. The proposal is a treaty-level or coalition arrangement in which public payers deposit net prices per oncology product into a secure registry visible to other participating payers (not to the public or industry), with aggregate transparency published annually. Beneluxa and the Nordic Pharmaceutical Forum already share some information.
Hypothesis
Payers with access to the registry achieve net prices at least 10% lower than non-participants for the same products within three years, and the dispersion of net prices across similar-income countries narrows.
Rationale
Information asymmetry favours the seller in every negotiation; shared price intelligence is standard practice among large purchasers in other sectors and is the cheapest lever payers have.
What would test it
Establish the registry among five to ten European payers for oncology products, and compare their net price trajectories with matched non-participating payers using confidential data audited by a neutral party.
Maturity
speculative
Who has to act
payer
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
- 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.
- Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.