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Challenges to Licensing from Some Publishers

Last revised: January 14, 2015
Ivy Anderson, Director
Collection Development and Management
California Digital Library

The University of California libraries and the California Digital Library facilitate access to online resources through systemwide negotiation and licensing. At the same time, we seek to influence the marketplace through consortial licensing decisions. We think that we can best serve the long-term interests of UC faculty and students by insisting on resources that meet high standards for content quality, fair and affordable pricing, and licensing terms that allow broad access to our user community.

With a few publishers, these standards fall far short and become roadblocks in the licensing process. The following information is provided to explain to the UC community why systemwide licenses are not yet available for certain online resources. We continue to monitor these publishers and their licensing models in hopes of negotiating reasonable and acceptable terms for UC-wide access.

In most cases, the roadblocks to licensing center on sustainable pricing. There are serious budgetary issues facing the UC libraries which are discussed in a related public letter.

ClinicalKey (Elsevier Clinical Solutions)

After a year of careful consideration and analysis, the University of California Libraries decided not to subscribe to ClinicalKey in 2015. ClinicalKey is the broader in scope, replacement product for MD Consult (medical textbooks and journals). While the many resources on the new platform might be useful to our patrons, our strong reservations about the astronomical cost, the inflexible content model and lack of perpetual access to content have ultimately caused us to turn away from the deal.


  • Our initial consortial quote for ClinicalKey was a 300% increase over what we had paid in 2014 for MD Consult and included multi-year pricing. The fifth year’s price accounted for an increase of over 56% over the course of five years. At the end of the 5-year contract, we would have paid 4.6 times what we had paid in 2014.
  • The UC’s final quote for ClinicalKey was an increase of nearly 95% over what we had paid in 2014 for MD Consult. Local quotes received by campuses for individual campus subscriptions were even higher.
  • Most of the UC campuses have been facing either reduced or flat budgets for the last few years and finding additional funds to pay for ClinicalKey would require our campuses to sacrifice other content we are not willing or able to cancel.
  • It took many months and repeated requests to receive updated MD Consult usage reports and an initial price quote for ClinicalKey. When we asked for a reduced quote, it took six months to receive. We repeatedly requested an updated multi-year quote and never received it. Due to the continual lack of responsiveness of ClinicalKey staff, the UC libraries had no option but to move ahead with replacement strategies for the critical medical content.
Content model
  • Elsevier has bundled nearly all of its clinical texts into the ClinicalKey platform. While it makes sense for them to charge more for a product that has more content than MD Consult, we did not request access to this additional content nor do we want to subscribe to all of it.
  • Being able to pick what content we subscribe to on the ClinicalKey platform was not an option. While there are specialty collections that can be subscribed to instead of the entire database, the ClincalKey representative indicated that the cost for selecting a limited number of these specialty collections exceeds the cost for the entire ClinicalKey database because of the UC consortium size.
  • Purchasing ebook titles for these key texts a la carte on ScienceDirect is also not an option that has been offered.
  • The UC health sciences libraries noticed that Elsevier drastically increased the prices of their clinical ebooks on other delivery platforms such as eBrary and EBL. In addition, ClinicalKey announced that future ebook editions of clinical texts will not be offered on non-Elsevier delivery platforms, effectively making ClinicalKey the sole delivery platform for its clinical texts.
Perpetual Access
  • The University of California has a long history of advocating the need for publishers to provide perpetual access to content. In the past, for print formats of clinical texts or journals, the UCs still had access if a subscription was cancelled. In the current model for ClinicalKey, the annual subscription cost is a content rental fee. No content is guaranteed for future access. Should we choose to no longer subscribe to the resource, all access ends despite payment during the previous years.

Due to the unreasonable and unsustainable cost models, the inflexible content selection option, and the lack of perpetual access to content, the University of California Libraries will not subscribe to the ClinicalKey product in 2015.

UpToDate (submitted by the UC Health & Life Sciences bibliographer group)

UpToDate is a popular online point-of-care clinical information resource that most of the UC Health Sciences Libraries wholly or partially fund for their campus' healthcare providers and medical students. Unfortunately, UpToDate's refusal to allow remote access to authorized users as part of their basic license fee, or to charge a reasonable extra amount, is of great concern to UC libraries. A recent price which UpToDate provided to UCSD to provide remote access with its contract would have cost an estimated $250,000 annually, on top of the annual license fee. Numerous UC and other academic health centers have raised this concern with UpToDate because their remote access policy is not in keeping with the policies of other publishers.

Remote access is vital for the UC community. Physicians often need to consult information resources in response to patient care needs while off-site. Affiliated medical students and residents often work rotations in clinical locations outside of the UC, or want to learn more about conditions they encountered as part of their studies from home. UpToDate's practice of not permitting remote access as part of the basic license fee falls outside the norms of pricing and standard features for electronic content. Due to this, the University of California Health and Life Sciences librarians feel obligated to alert the UC community about UpToDate's unacceptable licensing practices.

Past Activities

Nature Licensing Update (2012, 2007 and 2001)

Previous challenges including AAAS and Informa (2003-2011)

Last updated: March 16, 2015
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