In 2013, more than half the world’s poor continue to lack access to essential medicines, despite a multitude of global health diplomacy efforts to increase access to affordable medicines in low and middle-income countries. This failure is exemplified in Millennium Development Goal (MDG) Target 8E which aims to increase access to affordable medicines, yet fails to address key causes of unaffordability, including trade-related intellectual property rights under World Trade Organization (WTO) and bilateral and regional free trade agreement rules. This commentary argues that addressing these price impacts is key to effectively advancing access to medicines and that such measures should be incorporated into goals to replace the MDGs after they expire in 2015. One way to do so is through the use of human rights impact assessment (HRIA) of trade-related intellectual property rights to mitigate the price impacts of these rights and realize state duties in order to provide access to affordable essential medicines. An HRIA requires policy makers to assess the impacts of trade-related intellectual property rights on medicine affordability and access, and to accordingly remedy any negative impacts on medicines access. Multiple global health and human rights actors and institutions endorse their use, and significant attention has been brought to developing effective, robust and user-friendly methodologies. Global policy makers formulating post-2015 access-to-medicine goals should ensure that HRIAs are adopted as a pragmatic and widely agreed upon means of protecting drugs from a key structural determinant of inaccessibility, and realizing universal access as a prioritized aspect of the right to health.