Determining fair medicines prices. What do citizens think?

• Citizens support fair medicine prices balancing access and R&D costs. • They favour fair negotiation processes over additional therapy benefits. • Negotiation should consider societal, scientific and economic factors. There is a lively debate about the fair price of medicines, mainly led by experts. Little is known about the public’s opinion, although in most health systems with universal coverage medicines are procured by payers or governments, i.e. public money. This study assesses public opinion about fair medicine prices, the criteria that define fairness, and the policy implications. A population survey amongst 1000 people across the Swiss population in all 3 language regions has been conducted between September and October 2024. Access for all (986), transparency of the cost structure (914) and a price reflecting the costs of a medicine (911) have ranked as the most relevant factors for a fair price of medicine. In contrast, the additional benefit of a new therapy is considered less important as a criterion. A large majority supports pharmaceutical companies making a profit. Asked how to align the different objectives, the majority supports the statement that medicines prices should be the result of a fair process (568), followed by the statement that governments should control profits (431). This study suggests that citizens consider the balance between patient access and investment in research and development as the most relevant for a fair price of a medicine. When access and cost create a dilemma, citizens favour fair procedures. In contrast to expert opinions, the additional benefit of a medicine seems to be a less relevant criterion. The survey results indicate a nuanced and pragmatic approach to fairness, considering societal, scientific, and economic factors.