As companies work to improve access to medicine in low- and middle-income countries, they need to understand “what works” and ensure initiatives are effective so that they demonstrate and build on progress. Stakeholders such as governments, NGOs and communities increasingly expect pharmaceutical companies to set measurable goals and targets for access initiatives. Nevertheless, to make progress sustainable, companies must also measure long-term effects on healthcare systems and populations. Five companies demonstrate best practice in this area: GSK, Sanofi, MSD, Novartis and Takeda.

GSK and Sanofi: Strong on partnerships  
GSK measures long-term effects through its community investment partnerships with Save the Children (child mortality), Comic Relief (malaria) and Positive Action and Fast Track Cities (both HIV). With Save the Children, it measures and reports on impacts in multiple access programmes. With Comic Relief, it has metrics to evaluate how it strengthens health systems in countries in sub-Saharan Africa and the Greater Mekong region (e.g. Cambodia and Myanmar) where malaria is endemic. GSK is also developing an impact assessment dashboard to evaluate initiatives across the board.

Sanofi works with external partners to measure and publish information about long-term impacts of its access-related projects. One example is a study published in The Lancet Oncology (2018) on Sanofi Espoir Foundation’s cancer care My Child Matters programme in low- and middle-income countries. Another is a three-year research partnership with the Institute of Epidemiology and Tropical Neurology (France) to evaluate not just outcomes but also long-term impacts of an initiative in Armenia, Madagascar and Myanmar (three countries in scope of the Index) to increase access to mental health care.

MSD: Focus on maternal health 

MSD is unique in reporting a focus on maternal health. It measures impacts of MSD for Mothers, an initiative to address maternal mortality rates and support pregnant women. Its Evidence for Impact research compendium (2018) outlined how research can facilitate action on maternal mortality. Partnerships include that with London School of Hygiene and Tropical Medicine, whose demographic health survey helped MSD understand where women seek family planning services. Knowledge of preferences has helped the company develop tools to ensure women get access to contraception and tailor programmes to improve health. 

Novartis: An alternative approach 

Novartis takes a highly systematic approach. For several years, it has worked to develop, test and apply a new methodology to measure societal impact in financial, environmental and social (FES) terms. Through ‘social impact valuation’, Novartis has calculated the outcomes of multiple innovative products in its portfolio across 117 countries. By consistently evaluating value, it aims to understand how to build trust with society. Measuring and evaluating impact is also helping Novartis to tailor access initiatives and make them more cost-effective. Research involves assessing societal needs (for example, indicators such as wages in places where it operates) to improve access to medicine and strengthen systems. 

Takeda: A new framework 

Takeda is partnering with US-based Duke University to develop the Access to Health Impact Measurement Framework. Through this, it plans to measure company strategy and programmes by continuously assessing and responding to patients’ needs and monitoring impacts on healthcare systems. Goals for the framework include using it to identify complementary programmes and areas for deeper collaboration, and more efficient and effective deployment of resources. Takeda’s stated ambition is to implement the framework across its healthcare sectors to create one consistent tool to measure impact enabling improvement in patients’ lives. Now testing the framework, the company aims to launch this and make it publicly available by 2021.