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

Source: https://onco.cc/ideas/idea-acc-eml-listing-price-commitments/  
OnCo record `idea-acc-eml-listing-price-commitments` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed test: 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
- Actor: policy

## Sources

- WHO Model Lists of Essential Medicines: https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/essential-medicines-lists

## Connected records

- drugs: [Imatinib](https://onco.cc/drugs/imatinib/), [Trastuzumab](https://onco.cc/drugs/trastuzumab/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)
- roadmaps: [Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation](https://onco.cc/roadmaps/global-access-roadmap/)

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