A research programme by the Access to Medicine Foundation

Research & Development

There is a huge demand for R&D that meets the needs of people living in low- and middle-income countries. For example, new products are needed for infectious diseases such as malaria, as well as for tropical parasitic diseases. Large R&D-based pharmaceutical companies are best placed to develop such products and bring them to market.

  • Commitments
  • Transparancy
  • Performance
  • Innovation
1 = GlaxoSmithKline plc
4.00

GlaxoSmithKline plc

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2 = Merck KGaA
3.69

Merck KGaA

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3 5 Novartis AG
3.55

Novartis AG

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4 3 Johnson & Johnson
3.19

Johnson & Johnson

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5 4 Sanofi
2.83

Sanofi

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6 8 Eisai Co. Ltd.
2.80

Eisai Co. Ltd.

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6 7 Takeda Pharmaceutical Co. Ltd.
2.80

Takeda Pharmaceutical Co. Ltd.

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7 9 Daiichi Sankyo Co. Ltd.
2.71

Daiichi Sankyo Co. Ltd.

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8 12 Bayer AG
2.14

Bayer AG

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9 15 Novo Nordisk A/S
2.09

Novo Nordisk A/S

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10 = AstraZeneca plc
2.05

AstraZeneca plc

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11 17 Astellas Pharma Inc.
2.01

Astellas Pharma Inc.

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12 6 AbbVie Inc.
1.98

AbbVie Inc.

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13 14 Pfizer Inc.
1.90

Pfizer Inc.

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14 19 Roche Holding AG
1.84

Roche Holding AG

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15 11 Merck & Co., Inc.
1.78

Merck & Co., Inc.

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16 13 Boehringer Ingelheim GmbH
1.73

Boehringer Ingelheim GmbH

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17 20 Bristol-Myers Squibb Co.
1.56

Bristol-Myers Squibb Co.

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18 16 Gilead Sciences Inc.
1.43

Gilead Sciences Inc.

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19 18 Eli Lilly & Co.
0.88

Eli Lilly & Co.

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0 1 2 3 4 5

Top four extend lead by performing well in access planning and priority R&D

GSK extends its lead, followed once again by Merck KGaA in 2nd. Novartis rises to 3rd. The group divides into four groups: four clear leaders (GSK to Johnson & Johnson), a closely packed upper-middle group of four (Sanofi to Daiichi Sankyo), a large lower-middle group (Bayer to Boehringer Ingelheim) and a lagging group of three. The distance between the highest and lowest scores has widened (by 0.8) since 2016. Nearly three quarters of companies have processes to establish access plans during development, but quality varies. Most companies score well for their codes of conduct governing clinical trials and for how these codes are enforced.


Leaders systematically plan for access

The four top-ranked companies have pulled further ahead in 2018. Novartis edges into 3rd as Johnson & Johnson falls to 4th. The four stand out for having innovative practices and are generally among the top performers in: (1) having detailed, concrete commitments to R&D for diseases and countries in scope; (2) planning for access during development; (3) pipeline size; and (4) R&D for priority targets.  

GSK leads; 67% of its pipeline targets R&D priorities, and it has an innovative integrated Global Health R&D Unit that systematically plans for access for clinical candidates.  Merck KGaA (2nd); 43% of its pipeline targets R&D priorities. Its innovative Merck Global Health Institute is dedicated to developing affordable and available therapies for infectious diseases, including malaria and schistosomiasis.  

Novartis (3rd) has an innovative approach to systematically developing access strategies for all new medicines via the Novartis Access Principles.  It also commits to evaluating trial participants’ need for further medication once clinical trials are completed. 

Johnson & Johnson (4th) has the largest pipeline of the four (2nd largest overall). Its Innovation Center actively seeks partnerships to accelerate development of affordable novel therapies for diseases that disproportionately affect countries in scope. 

Top 10 typically perform well in priority R&D and access planning

Companies in the top 10 typically have strong commitments to R&D for diseases in scope, are more engaged in priority R&D and plan for access for late-stage candidates. The top five performers in R&D are also the top five companies by number of priority R&D projects in the pipeline. Roche rises 5 (to 14th), with a new, clear policy on providing clinical trial participants with post-trial access to candidate medication. It invests a comparably higher proportion of its revenue into R&D for diseases in scope. 

AbbVie falls 6 (to 12th) due to a lack of transparency and/or detail in several areas, including its process to establish access plans during development and its policy on post-trial access. 

Remaining companies falter in planning for access

The upper-middle group (Sanofi in 5th to Daiichi Sankyo in 7th) includes strong performers in priority R&D and applying access plans to late stage R&D, but in order to be leaders they must strengthen their commitments, especially their processes to develop access plans and commitments for post-trial access. 

Most companies in the large lower-middle group (Bayer in 8th to Boehringer Ingelheim in 16th) perform less well in: (1) planning for access; (2) policies for providing post-trial access to candidate medication; and (3) R&D for priority targets. The lowest three companies (Bristol-Myers Squibb, Gilead and Eli Lilly) perform poorly across multiple indicators. They do not disclose their R&D investments to the Index and have small pipelines. They are the only companies that did not provide detailed information on how they audit and monitor clinical trials for unethical conduct. 

AbbVie, Eli Lilly and Merck & Co., Inc. drop to lower ranks largely due to generally low transparency in several key areas, with Merck & Co., Inc. the most publicly transparent of these three. 


Learn more

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