Pharmaceuticals have undoubtedly contributed to improvements in life expectancy and quality of life of many patients. Medicines can cure, relieve symptoms, delay the onset of disease and prevent complications. They often offer good value for money. Recent trends, however, raise a number of concerns. The launch prices of new drugs have been soaring in some therapeutic categories, sometimes without commensurate health gains. At the same time, new effective medicines are not always affordable to all patients who need them and put a high pressure on health care budgets. Such trends raise questions about incentives at work in the pharmaceutical sector and the sustainability of current pricing models.


Pharmaceutical spending accounts for approximately 20 percent of total health spending in OECD countries when taking into account medicines dispensed in both outpatient and inpatient settings of care. Recent developments in the pharmaceutical market and spending raise concerns for the future:

  • Spending has become increasingly skewed toward high-cost "specialty medicines." They now account for 30 to 50% of pharmaceutical spending in OECD countries and will be the main contributor to spending growth in the future
  • Launch prices of new medicines have been soaring in some therapeutic categories. In the United States, the prices of new cancer medicines now typically exceed USD 10,000 per month and one was launched at USD 64,000 per month. The prices of orphan medicines are also very high

  • In oncology and in rare diseases, high prices are not always commensurate to high benefits. The cost per life year gained of new cancer drugs was multiplied by four between 1995 and 2013 in the United States, even when adjusted for inflation. It now exceeds USD 200,000. For orphan medicines, incremental costs per QALY gained often exceed USD 100,000 and has been assessed to exceed USD 1 million in extreme cases
  • New hepatitis C treatments, which represent a real breakthrough for patients, have been launched at a list price of up to USD 84,000. They were assessed as cost-effective at this price. Although payers obtained discounts on this list price, treating the whole patient population was just unaffordable in many countries. While the price constituted a real barrier to access, the company recouped 25 times the initial outlay in R&D in less than two years

OECD Health Committee delegates have recognised the growing importance of sustainability in pharmaceutical access, and convened expert workshops in 2015 and 2016 to discuss good practice to address the issue. OECD also frequently works with its Business and Industry Advisory Committee to envision an innovation model that meets the needs of all health stakeholders.

Sustainable access to innovative THERAPIES - Overview of the project

The French Minister of Health has asked the OECD to act as the Secretariat for a new initiative to promote an international and high-level dialogue between stakeholders on access to innovative pharmaceuticals and sustainability of pharmaceutical spending. The initiative was endorsed by OECD member countries and by Health Ministers at the G7 Health Ministerial meeting in Kobe, on 11-12 September 2016.

In this capacity, the OECD will:

  • Convene a high-level expert group to reflect on innovative options to pay for new medicines, guaranteeing patient access to innovative treatments, sustainability of health spending, and continued innovation that meets patient needs
  • Conduct a prospective study to assess the sustainability of pharmaceutical spending
  • Organise stakeholder consultations to gather diverse experiences and ideas

The prospective study focuses on therapeutic areas where new medicines are very costly and/or have a high budget impact for health systems: oncology, rare diseases, HIV, Hepatitis C, diabetes and Alzheimer's disease. The overall objective is to improve patient access to innovative treatments and ensure the sustainability of health spending as well as continued innovation that meets patient needs.

Thirteen countries have agreed to actively contribute information and data to the prospective study: Belgium, Chile, Colombia (OECD candidate country), France, Germany, Israel, Japan, Mexico, the Netherlands, Norway, Switzerland, the United Kingdom and the United States.


The online consultation has now ended, and a consultation meeting for civil society to contribute their views on sustainable access to innovative therapies was held in Paris on 20 June 2017.










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