A research programme by the Access to Medicine Foundation

General Access to Medicine Management

Achieving greater access to medicine requires companies to view access to medicine as a strategic issue and to manage it as such, with clear goals and objectives and commitment from top management.

  • Commitments
  • Transparancy
  • Performance
  • Innovation
1 = Novartis AG

Novartis AG

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2 19 Roche Holding AG

Roche Holding AG

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3 = GlaxoSmithKline plc

GlaxoSmithKline plc

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4 6 Johnson & Johnson

Johnson & Johnson

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5 2 Novo Nordisk A/S

Novo Nordisk A/S

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6 16 Takeda Pharmaceutical Co. Ltd.

Takeda Pharmaceutical Co. Ltd.

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7 = Sanofi


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8 10 Merck KGaA

Merck KGaA

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9 13 Pfizer Inc.

Pfizer Inc.

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10 4 Merck & Co., Inc.

Merck & Co., Inc.

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11 5 AstraZeneca plc

AstraZeneca plc

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12 8 Eisai Co. Ltd.

Eisai Co. Ltd.

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13 15 Bristol-Myers Squibb Co.

Bristol-Myers Squibb Co.

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14 9 Eli Lilly & Co.

Eli Lilly & Co.

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15 17 AbbVie Inc.

AbbVie Inc.

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16 11 Bayer AG

Bayer AG

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17 14 Boehringer Ingelheim GmbH

Boehringer Ingelheim GmbH

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18 12 Gilead Sciences Inc.

Gilead Sciences Inc.

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19 20 Daiichi Sankyo Co. Ltd.

Daiichi Sankyo Co. Ltd.

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20 18 Astellas Pharma Inc.

Astellas Pharma Inc.

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0 1 2 3 4 5

Roche joins leading group in high-scoring area

There are now five leaders with two companies out in front. Novartis retains 1st place, but is now closely followed by Roche (2nd). GSK remains in 3rd. Companies score comparatively highly in this area, with half scoring 3 or above. Clear divides have opened up between the highest-ranking companies (Novartis to Novo Nordisk), those in the middle (Takeda to Boehringer Ingelheim) and those lower down. In 2016, companies were more tightly packed. There are three laggers, although Astellas and Daiichi Sankyo lag noticeably behind Gilead. 

Leaders have commercially aligned strategies

There are five companies pulling ahead in 2018, with three newcomers in the group and two frontrunners (Novartis and Roche). These five have (1) company-wide strategies for improving access to medicine, with clear objectives aligned to corporate strategies; (2) solid approaches to stakeholder engagement; (3) typically disclose both their selection process and the stakeholders they engage with; and (4) have systems for incorporating perspectives from local stakeholders into strategies. 

Novartis (1st) leads once again. It meets all Index criteria on transparency in this area, including public disclosure of commitments, measurable objectives and performance information. It is deploying an innovative business model, Novartis Access, that focuses on products for non-communicable diseases (NCDs) in 24 resource-limited countries. Roche (2nd) rises 17 places, improving its score across the board. It has reviewed its access strategy, now including an Access Planning Framework, which focuses on awareness and diagnosis. Roche’s innovative Global Access Program aims to expand sustainable access to diagnostic HIV/AIDS testing in endemic countries. 

GSK (3rd) performs well in managing access-to-medicine outcomes, but is less transparent than leaders in publishing information about stakeholder selection. It has scaled up its innovative programme (Live Well) in Zambia for recruiting and training local community health entrepreneurs, who become ‘last-mile’ distribution agents and contribute to strengthening the national health system. Johnson & Johnson (4th) is close behind GSK. Like other leaders, it has put structures in place to incentivise senior managers to deliver results for access initiatives over the long term. Novo Nordisk (5th) remains in the leader group. It continues to perform well in multiple areas, but has been outpaced by the other leaders.

Climbers renew access strategy and assign top responsibility

In 2018, two companies make significant rises through the ranks.  Roche rises 17 (to 2nd), driven by increasing transparency, a renewed access-to-medicine strategy, and innovative model focused on HIV/AIDS diagnosis. Takeda rises 10 (to 6th), as it newly assigns responsibility at board level for its access strategy, and improves its governance structures. It also receives credit for innovative work with the Cancer Alliance in Nairobi.  

Eli Lilly falls 5 (to 14th), as it is affected by an overall lack of transparency across several areas of measurement. For example, it no longer provides evidence of sharing its stakeholder selection process. Gilead falls 6 to (18th), out of the mid-ranking group. It is overtaken by peers in several areas. For example, it still does not demonstrate evidence of having direct board responsibility for its access approach. 

Mid-ranking companies are tightly packed

Companies ranked between 6th and 17th place (Takeda to Boehringer Ingelheim) are clustered, all scoring within one point. These companies all perform less well than leaders in disclosing information about stakeholder engagements: i.e., their selection processes and/or the groups they engage with. 

Most mid-ranking companies generally perform less well when it comes to publicly reporting how they manage access-to-medicine outcomes. None of the three lowest-ranking companies Gilead (18th), Daiichi Sankyo (19th) and Astellas (20th) demonstrate having access-related incentives for senior management that are based on long-term performance. Gilead does not publish any information relating to stakeholder engagement, while Daiichi Sankyo and Astellas do not publish their stakeholder selection processes.  These three generally perform poorly compared to other companies on transparency measures.  

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View our detailed overview of each company’s performance in the Index, including breakdowns of their product portfolios and R&D pipelines.