High Price, High Quality? Rethinking Medicine Pricing and Trust in LMICs

Building on the 2025 World Health Summit session on medicine quality, this session shifts the focus to one of the most sensitive and politically charged dimensions of pharmaceutical policy in low- and middle-income countries (LMICs): medicine pricing, with attention to essential medicines and emerging regional governance mechanisms.

A persistent assumption continues to shape prescribing practices, patient behavior and regulatory debates in many settings: high price equals high quality. This perception directly affects access to essential medicines, undermines confidence in quality-assured generics, fuels out-of-pocket expenditures, and may paradoxically increase exposure to substandard and falsified products.

At the same time, pricing policies for essential medicines are increasingly shaped by regional regulatory and market dynamics, particularly in Africa, where the African Medicines Agency (AMA) represents a major step towards regulatory harmonisation, strengthened oversight, and improved access to quality-assured medicines. Yet, questions remain regarding how pricing, procurement, and perceptions of quality intersect with these new governance frameworks.

This session will critically examine how price, essentiality and trust interact, and how misaligned price signals may weaken equitable access to medicines, even when regulatory quality standards are met.

Speakers will discuss:
• How price influences perceptions of quality for essential medicines;
• The role of regulatory authorities and regional agencies such as the AMA in reinforcing trust;
• Tensions between affordability, market incentives and public health priorities;
• Policy levers to better align essential medicine lists, pricing strategies and regulatory credibility.