A view of the COVID-19 isolation ward inside Gallup Indian Medical Center (GIMC), a hospital in Gallup, New Mexico, in Navajo Nation. MSF advised the GIMC on patient flow for COVID and non-COVID patient and infection prevention control measures. Photograph by Jake Pitts
Technical brief |

Transparency Matters: Disclosing the Costs of Publicly Funded Research & Development for COVID-19 Medical Tools and Beyond

Photograph by Jake Pitts

High prices limit people’s access to lifesaving vaccines, therapeutics, and diagnostics the world over. The pharmaceutical industry often claims that the high costs of research and development (R&D) – clinical trials, in particular – justify high prices for drugs and other medical tools, yet they do not disclose these costs in any detail. The struggle against COVID-19 in the United States (US) and around the globe only makes clearer the urgent need for medical tools that are accessible and affordable to everyone. Public dollars are pouring into COVID-19 R&D at an unprecedented rate in the US, but there is little transparency regarding what those public funds are used for, including the actual costs of COVID-19 clinical trials. Without this information about COVID-19 and all other federally funded R&D, lawmakers and the public cannot assess the fair pricing of products resulting from taxpayer-supported R&D investment, negotiate lower prices based on true costs, nor design policies to orient future innovation toward public health needs.

This briefing document outlines how US government agencies that fund R&D, particularly those under the Department of Health and Human Services (HHS) including the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority (BARDA), should be required to disclose the costs of all clinical trials they fund. The US is home to most of the largest pharmaceutical and biotechnology companies and spends more on publicly funded biomedical research than any other nation, and far more than any nation on the purchases of drugs and other medical products per capita. US leadership on transparency would have a significant impact on the biomedical innovation system both globally and domestically, helping to better align prices, product development, and public health, delivering more affordable and accessible products that respond to the health needs of everyone.