Modern medicines, vaccines, and other health technologies have revolutionized health care. Yet these products haven’t improved lives everywhere, often because health systems haven’t made them accessible and affordable. In many developing countries, where health systems still rely heavily on out-of-pocket expenditure, patients face high costs at the point of service. Some people forgo necessary care; others endure financial hardship or even impoverishment. A majority of out-of-pocket spending goes towards medicines.