Proactive transparency: price indexes and citizen rights

Transparency can go a long way to help prevent corruption at all stages of the health delivery chain.

At the procurement stage, public disclosure of medical goods’ supply prices can help prevent collusion. Government ministries can cooperate with private companies to update and publish market prices related to medical equipment and pharmaceutical supplies to keep hospitals and other healthcare facilities from being overcharged. This includes establishing lists of reliable and well performing suppliers as well as making price information widely available and providing information on the availability of less expensive drugs by smaller pharma companies. At the global level, initiatives such as the WHO’s Drug Price Information Service or the MSH International Price Guide aim to make price information more widely available to allow comparisons in order to improve procurement of medicines for the lowest possible price.[1]

The impact of price transparency on hospital corruption in Buenos Aires

In the late 1990s, the city of Buenos Aires started collecting information about prices paid for a wide range of medical supplies – including needles, syringes, intravenous solutions, x-ray films and sanitary materials – and reported back this information to hospital procurement offices, allowing comparisons for basic medical goods and services. The publication of hospital procurement prices revealed a very wide dispersion of prices, up to 10 times higher in some facilities than in others. Purchase prices for the monitored items immediately fell by an average of 12 per cent, possibly due to fear of detection by corrupt procurement officers. Prices eventually began to rise again, but stayed below the baseline purchase price. However, lessons from this experiment establish that, unless there are consequences for fraud and malpractices, monitoring and publishing price information is unlikely to guarantee sustained gains over time.[2]

Information about tender processes, including offers to tender, terms and conditions, the evaluation process and final award decisions should be made publicly available online and subject to public scrutiny.  

Integrity pacts can also be used for preventing corruption in health procurement. These consist of a signed document committing a contracting authority and all bidders to comply with best practice and maximum transparency. They are typically monitored by a third independent actor, usually a civil society organisation.   

The public also need to be informed on drug development and effectiveness. Medical associations can provide governments with information about drug trials, composition, effectiveness and adverse effects. Effective nationwide systems for reporting adverse drug effects can be established and physicians incentivised to report such effects. Reporting by the drug industry on clinical drug trials should also be made mandatory and a public database listing the protocols and results of all clinical drug trials be accessible to the public. There are online platforms that publicise the findings of drug trials, such as the WHO’s clinical trial database or the US National Institute of Health‘s database. All financial contributions made to medical research units from pharmaceutical companies should also be disclosed.[3]

Proactive transparency can be useful at the point of service delivery to inform citizens about their rights and entitlements when accessing health services. This includes their rights to privacy and the cost of the services to prevent patients from being charged for services that are supposed to be free. 



Iñaki Albisu Ardigó; Marie Chêne


Matthew Jenkins

Contributing experts:

Umrbek Allakulov (Water Integrity Network)

Shaazka Beyerle (US Institute of Peace)

Simone Bloem (Center for Applied Policy)

Claire Grandadam (Water Integrity Network)

Jacques Hallak (Jules Verne University – Amiens)

Mihaylo Milovanovitch (Centre For Applied Policy)

Muriel Poisson (International Institute for Educational Planning (IIEP-UNESCO)

Juanita Riano (Inter-American Development Bank)

Marc Y. Tassé (Canadian Centre of Excellence for Anti-Corruption)

Vítězslav Titl (University of Siegen)

Davide Torsello (Central European University Business School)

Patty Zakaria (Royal Roads University)



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