{"entity":{"id":"idea-reg-net-price-transparency-registry","kind":"idea","name":"An international registry of real (net) cancer drug prices paid by public payers","aka":[],"tldr":"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.","summary":"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 one of the main drivers 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.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prices and value): Prasad, De Jesús & Mailankody, The high price of anticancer drugs: origins, implications, barriers, solutions (Nat Rev Clin Oncol 2017)","url":"https://doi.org/10.1038/nrclinonc.2017.31"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-drug-pricing","b-data-silos"],"keyPapers":["paper-prasad-nat-rev-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"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.","test":"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","actor":"payer","cost":"small","horizonYears":3},"route":"/ideas/idea-reg-net-price-transparency-registry/","neighbours":{"bottleneck":[{"id":"b-data-silos","kind":"bottleneck","name":"Data silos","route":"/bottlenecks/b-data-silos/"},{"id":"b-drug-pricing","kind":"bottleneck","name":"Prices and value","route":"/bottlenecks/b-drug-pricing/"}],"paper":[{"id":"paper-prasad-nat-rev-clin-oncol","kind":"paper","name":"The high price of anticancer drugs: origins, implications, barriers, solutions","route":"/key-papers/paper-prasad-nat-rev-clin-oncol/"}]}}