Access-to-medicine goals are one step closer to being accomplished when, among others, senior management executives within pharmaceutical companies engage in and are responsible for such strategies. GSK, Novartis, Pfizer and Takeda offer leading examples of best practice in governance of access as they establish long-term incentives for top-level managers, maintaining, thus, access to medicine as a pillar of their business operations. These companies have board-level committees that take direct responsibility for access strategies.  

At GSK, long-term incentives programmes for senior management link access-related objectives to its global health strategy for its CEO and others. The CEO’s personal access-related objectives relate to malaria, tuberculosis and paediatric HIV programmes, as do objectives for senior executives and regional and in-country managers in countries in scope of the Index. In 2020, for example, some objectives for GSK in-country and regional managers (e.g. the South Africa country manager) related to supporting global health, vaccines and HIV access initiatives (the latter being under the joint venture of ViiV Healthcare). Performance is measured against these objectives, with incentives awarded accordingly. 

Novartis, recognised as a strong performer in access management in 2018, continues to exemplify this approach. It embeds its access principles into governance structures and applies access thinking to its core business at the highest level. Long-term financial incentives programmes for senior staff include specific access-related objectives for its CEO in line with a performance plan. Annual objectives are linked to variable compensation and the company publishes information on how its CEO’s performance-related pay is based on strategic objectives such as building trust with society (including access to healthcare and environmental, social and corporate governance).

Since 2019, Novartis has set its managers specific incentive-related targets for access to medicine and global health. Balanced scorecards, measuring the performance of executive committee members, include dates by which numbers of patients reached in low- and middle-income countries should be increased with innovative drugs and strategic brands. One example of access-related objectives for regional managers comprises targets linked to patient reach, set for the Kenya-based head of the company’s new sub-Saharan Africa business unit. 

At Pfizer, there is direct board-level responsibility for access. Pfizer’s CEO has incentives based on access targets linked to its Purpose Blueprint strategy, which aims at accelerating patient impact. Takeda’s CEO has performance-based key performance indicators (KPIs), including access to medicine as a corporate strategic issue. As access is part of corporate KPIs, the CEO, the company executive team and the regional and in-country managers (for its Growth and Emerging Markets units) have access-related incentives. 

Focus on measurable goals needed

Five other companies (AstraZeneca, Bayer, Daiichi Sankyo, Novo Nordisk, Sanofi) demonstrate good practice by incorporating sustainability and social targets, which include access to healthcare initiatives, into their CEO objectives. Yet, they show less information on measurable objectives and how these incentives specifically focus on the achievement of their access-to-medicine strategy.