I can still remember that fateful day some years ago when I was sitting with a minister for health in their office and being told the government had decided not to list several new medicines on the government’s reimbursement formulary. This was even though the medicines concerned had all been recommended for listing by the government’s own independent, expert evaluation committee. The reason? The government just couldn’t afford it. Or, rather, the government had decided to sp

Anyone looking at the debate over health spending would think that health systems around the world are being bankrupted by how much countries spend on medicines. The debate about drug pricing, ranging through government and international inquiries, conference debates and presidential tweets, could give the impression to the unaware observer that spending on medicines is blowing health budgets out of control and countries simply can’t afford it. The political debate and rhetor