At Salud por Derecho, we’ve spent years working to ensure greater transparency in how medicine prices are determined. We believe that knowing how much the public system pays for treatments funded with public money is both a fundamental citizen’s right and an essential condition for building a fairer and more sustainable healthcare system.
Today, through the No es Sano campaign -which Salud por Derecho promotes- we’re publishing a new report that looks at how the lack of transparency in the net prices of medicines (that is, the actual prices after discounts and confidential deals) fuels limited access to treatments and growing pressure on public budgets. This lack of information isn’t an isolated issue; it’s the norm in many countries and carries particularly serious consequences for those with weaker negotiating power.
Our report challenges the notion that confidentiality protects lower-income countries. In fact, we document several cases where countries with fewer resources have ended up paying more for medicines than wealthier nations. Cases involving drugs for cystic fibrosis or COVID-19 vaccines are clear examples of this inequality.
In Spain, as you may know, we’ve been taking legal action since 2019 to obtain public information on the prices of high-impact medicines like Kymriah, Veklury, and Zolgensma. Although the Consejo de Transparencia y Buen Gobierno has ruled in our favor in several instances, pharmaceutical companies -and at times the Ministry of Health itself- have appealed these decisions, arguing that the information must remain confidential.
A significant development occurred in 2024, when for the first time, the Ministry of Health chose not to appeal a ruling requiring it to disclose the real price of remdesivir (Veklury). Since then, only the pharmaceutical industry has continued the legal battle. Yet the lack of transparency persists. We recently requested information on the pricing and criteria for the antiretroviral drug lenacapavir (Sulenca), and once again, the Ministry denied our request, citing confidentiality and the protection of commercial interests. This case adds to a long list of obstacles, highlighting the urgent need for a transparency framework that doesn’t rely on constant litigation.
This legal, technical, and political work aims to open the door to deeper change. Because this isn’t just about knowing the numbers; it’s about challenging a system that allows prices to be set without clear criteria, without accountability, and without putting the public interest at the center. Opacity leaves us in the dark during key negotiations that directly impact the health of millions of people.
In this report, we also propose concrete steps toward greater transparency: from conditioning public incentives on price disclosure, to ensuring access to this information in all publicly funded contracts and agreements. We also highlight good practices from other countries that could inspire change here and across Europe.
Transparency should not depend on long and costly legal processes. It must be a duty of public institutions and a guarantee for citizens. At Salud por Derecho, through the No es Sano campaign, we will continue working to make that a reality.
You can download the full report at this link.
