Product Delivery

Leaders expand their product delivery approach to boost access for lower-income countries

Novartis leads the way as the only company that implements an equitable strategy in lower-income countries for all products. Overall, Novartis and GSK target multiple countries and patient populations across the income pyramid with their access strategies e.g., equitable pricing and responsible IP management. Furthermore, they both leverage their know-how and resources to address local access barriers through their capacity building initiatives.

The top six companies in this area take more steps to try and reach more populations in need. They perform strongly in access strategies and registering their products widely in high-burden countries in scope. As well as supply chain capacity, the six companies perform well in building local manufacturing capacity, albeit focusing mostly on upper-income countries, and are particularly strong in health system strengthening initiatives. 

In contrast, middle performing companies generally use a less diverse range of equitable access strategies and tend to focus on upper- and middle-income countries rather than lower-income countries. They exhibit varied performances in this Technical Area due to their mixed approaches to registration, IP management, supply and manufacturing capacity building. 

The lowest ranked companies are markedly less transparent than their peers across several areas of assessment. They perform poorly when it comes to registration and access strategies. 

What does best practice look like?

Equitable pricing strategies are at the heart of patient-oriented business operations. Top-performing companies consider affordability and continuous supply to increase patient reach at all levels of the income pyramid. They enter into supranational procurement agreements and develop patient assistance programmes (PAP) to provide personalised, income-tailored support based on intra-country pricing solutions and economic conditions. 

As part of their health system strengthening initiatives, high-performing companies focus on educating and training health workers, raising public awareness and collaborating with local stakeholders. Mental disorders, cervical cancer, stroke, HIV/AIDS and non-communicable diseases are prioritised in their agenda due to the high incidence rates in certain countries and regions. 

Lastly, product donations continue to play an important role in eliminating, eradicating or controlling some diseases that affect populations living in low- and middle-income countries. For people living in poverty, donations may be their only chance of getting access to the treatment they need. Companies engaging in structured donation programmes to eliminate, eradicate or control the Neglected Tropical Diseases go beyond the WHO-determined goals to donate their products indefinitely and to larger patient populations.

Equitable pricing, voluntary licensing, product donations

In this area, the Index assesses the companies’ post-development actions on the ground to ensure they offer equitable access to their products and overcome any local barriers in accessing hard-to-reach markets and patient populations.

The choices pharmaceutical companies make in delivering their products are a critical factor for countries striving to achieve universal health coverage. As a first step, companies must register their products for sale where they are needed. They can then use three main access strategies: equitable pricing, responsible IP management and product donations. These are considered to have the biggest potential impact on supply and affordability. Actions such as sharing intellectual property and health-system strengthening are also considered here.