Open access has an awkward economics problem that nobody enjoys explaining. If readers do not pay, somebody else must, and in most of biomedical publishing that somebody is the author or their funder. This is the article processing charge — and it is the mechanism most exploited by publishers operating in bad faith.
So rather than a fee schedule, here is the thing worth understanding: what the money actually funds, the one structural question that separates a legitimate charge from a predatory one, and how not to pay it.
The question that matters is when, not how much
Authors comparing publishers almost always compare prices. It is the wrong comparison to lead with.
The decisive question is at what point the money becomes payable, because the answer tells you what the publisher's business actually is.
Our position: the APC becomes payable only if and when your manuscript is formally accepted for publication after peer review. If your manuscript is rejected, nothing is owed.
Follow the incentives and you can see why this matters. A publisher paid on acceptance earns nothing from a manuscript it declines — so rejecting weak work costs it money, and its only sustainable asset is a reputation worth submitting to. A publisher paid at submission earns the same fee whether it publishes your paper or bins it, which makes peer review a pure cost centre and volume the only thing that pays.
That is the whole mechanism behind predatory publishing, and it is visible in the payment terms before you ever read a word of the journal.
| Payment point | What it tells you |
|---|---|
| On acceptance | Standard practice. Rejecting weak work is costly to the publisher, so review has a purpose. |
| At submission | Serious warning sign. Revenue no longer depends on the decision. |
| Undisclosed until after acceptance | Serious warning sign. You cannot consent to a price you were not shown. |
| Rising after acceptance | Treat as a bad-faith charge and dispute it. |
What the charge actually funds
"Publishing costs" is not an answer. Here is the itemised version of what an APC pays for at this publisher.
Peer-review management
The unglamorous majority of the work. Identifying reviewers with the right expertise and no conflicts, issuing and chasing invitations, managing reports, handling revision rounds, and maintaining the systems that keep a double-blind process actually blind. Reviewers are unpaid; coordinating them is not free.
Editorial handling and copy-editing
Editorial oversight through the decision, then correction of grammar, consistency, terminology, reference formatting and structure after acceptance. This work disproportionately benefits authors writing in a second language — which, in medical publishing, is most authors.
Typesetting and production
Converting an accepted manuscript into a published article: layout, figure handling, table formatting, proofing.
Structured metadata and JATS XML
Producing the machine-readable version of the record. This is invisible to readers and is what makes an article harvestable, discoverable and preservable. Its absence is why some articles simply vanish from search over time.
Crossref DOI registration
Registering a persistent identifier and depositing metadata, so the article stays citable and resolvable even if URLs change. Crossref charges membership and per-deposit fees.
Similarity screening
Commercial screening services are licensed, not free, and are run on submissions regardless of whether those submissions are ever accepted — including the ones that generate no revenue at all.
Open-access hosting and distribution
Serving the content to anyone, anywhere, permanently, with no subscription. The cost does not end at publication; it continues for as long as the article exists.
Safeguarding the record
Preservation arrangements, correction and retraction handling, and the infrastructure that keeps the version of record intact. This is the part that has to outlive any particular publisher's commercial interest.
The three ways to pay nothing
A waiver policy that exists but is undiscoverable is a policy in name only. Ours has three routes.
1. Country-based need
Corresponding authors based in low-income and lower-middle-income economies are eligible for support. This is not charity; it is a correction. An author-pays model without geographic waivers systematically excludes exactly the researchers whose work is most needed in global health.
2. Unfunded or self-funded research
Authors whose research has no grant, institutional, departmental or third-party funding may request support. This route matters for clinicians writing up cases from their own practice, trainees, and researchers between grants — people doing legitimate work with no budget line for publication.
3. Discretionary
Circumstances that do not fit either category are considered on individual merit. If your situation is genuine but unusual, describe it rather than assuming the answer is no.
Support is either a full waiver, where the entire charge is removed, or a partial reduction.
How to ask — and when
Request at or before submission, not after acceptance. This is the single most common mistake authors make, and it is avoidable. Include:
- Manuscript title and submission reference
- Corresponding author's affiliation and country
- Funding status — state plainly that the work is unfunded if it is
- A brief statement of need. Two or three honest sentences. No documentation theatre required.
Requests are handled confidentially.
The separation that makes it fair
One structural point deserves emphasis, because everything else depends on it.
Waiver requests are handled administratively, entirely separately from editorial evaluation. The people assessing your manuscript are not the people assessing your waiver request, and asking for a waiver has no bearing whatsoever on the editorial decision.
This separation is what stops an author-pays model from becoming a pay-to-publish model. Without it, a publisher's revenue interest sits directly on top of its editorial judgement, and the ability to pay quietly becomes a publication criterion. With it, the decision on your science is made by people who do not know what you will be charged.
If you ever have reason to believe a waiver request affected an editorial decision here, that is a serious complaint and we want it raised.
Six fee questions to ask any publisher
Use these before you submit anywhere, including here:
- Exactly what will I be charged, in what currency, for this article type in this journal? A publisher unable to answer before submission is a publisher you should not submit to.
- At what point does it become payable? Acceptance is the correct answer.
- What happens if my manuscript is rejected? Nothing owed is the correct answer.
- Are there additional charges? Colour figures, page charges, supplementary files, "fast-track" fees. Get the total, not the headline.
- What is the waiver policy, and who decides? Look for separation from editorial decisions.
- What is the refund position if the article is later withdrawn or retracted? Rarely asked, and the answer is revealing.
What we will not do
For completeness, the practices we consider out of bounds: charging at submission; concealing the charge until after acceptance; increasing the fee after a decision; offering faster review in exchange for payment; letting editorial staff see waiver requests; or treating ability to pay as a factor in any editorial decision.
Full details are on the Article Processing Charges and Fee Waivers & Discounts pages, with related terms in Refund Policy and Open Access & Licensing. If a charge you were quoted does not match what those pages say, tell us — that is a discrepancy we would need to fix.