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The Internet is having a profound effect on health and medical information research, publication, communication, and retrieval. Many, if not most, life sciences and medical journals have launched online versions of their publications in recent years. And as this "migration" from print to electronic format has met with increasing success, journal publishers are also experimenting with a range of strategies for: 1) adding value for target user groups while 2) covering their evolving publication cost structures. At this point one key issue for all concerned is, Who should pay for access to online publications, and how?