But the real world seldom matches this idealized marketplace and the ways in which actual markets fall short of this ideal provide a helpful way to think about fair pricing. Consumers, of course, are not always fully informed nor fully free in the marketplace. Thus informed consent, a necessary condition for respecting autonomy, can be missing in some pricing situations. Pricing for such things as prescription drugs and other health care products are seldom things that consumers fully understand or for which they have alternatives available. The AIDS drugs in Africa case described in this chapter's discussion case pro¬vides a good example of such situations on a global scale. Among the millions of people in Africa who have AIDS, few have the education, understanding, and income sufficient to negotiate a price for AIDS drugs in an informed and free way. Patents for the drugs prevent competitors from entering this market and lowering prices through competition.