| Summary: | Medicines account for 20-60% of health spending in low- and middle-income countries, compared with 18% in countries of the Organisation for Economic Co-operation and Development. Up to 90% of the population in developing countries purchase medicines through out-of-pocket payments, making medicines the largest family expenditure item after food. As a result, medicines, particularly those with higher costs, may be unaffordable for large sections of the global population and are a major burden on government budgets. This guideline was developed to assist national policy-makers and other stakeholders in identifying and implementing policies to manage pharmaceutical prices. Although the feasibility of these policies in countries of all income levels was considered, special consideration was given to implementation needs in low- and middle-income countries, where the pharmaceutical sector may be less regulated. References to low- and middle-income countries are therefore intended to highlight specific implementation needs and do not to exclude the appropriateness for high-income settings
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