n engl j med 367;14 nejm.org october 4, 2012 1277 legislators, and patient advocates. The driving force behind the legislation was the need to reauthorize statutorily defined user fees that pharmaceutical manufacturers (since 1992) and medical-device manufacturers (since 2002) have paid when they submitted applications to the FDA for the evaluation of new products. The bill sailed through a clo...

OBJECTIVES Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. SETTING Women's experience of user fees in 5 African co...

The next iterations of the Generic Drug User Fee Act and the Biosimilar User Fee Act are meant to encourage new generic and biosimilar products, but higher fees and budget reductions may threaten progress.

In Africa, user fees constitute a financial barrier to access to health services. Increasingly, international aid agencies are supporting countries that abolish such fees. However, African decision-makers want to know if eliminating payment for services is effective and how it can be implemented. For this reason, given the increase in experiences and the repeated requests from decision-makers f...

Public recreation land management agencies have been searching for ways to increase revenue. User fees as implemented by the Fee Demonstration Program have received the most attention. Corporate sponsorships and private donations have also been implemented and other options, such as partial privatization, closure of some areas, and different forms of public-private partnerships have been debate...