Access strategies: Results Part II

Do companies extend access terms for countries outside supranational agreements?

This part two of a four part series, describes how supranational agreements help solved access challenges and takes a look at whether companies extend the same terms of access for their products to countries which are not covered by these agreements.

About this series: How do companies ensure worldwide access to their products?

Context Part I: Overview of how the Index assesses' companies access strategies for three categories of products: supranationally procured products, healthcare practitioner administered products, and self-administered products.
Results Part II: Supranationally procured products
Results Part III: Healthcare practitioner-administered products
Results Part IV: Self-administered products

Boosting access through supranational agreements
Multilateral organisations tend to purchase vaccines or medicines for heavy burden diseases such as HIV/AIDS, malaria and TB, on behalf of buyers e.g. health systems or countries. Such mechanisms for controlling HIV/AIDS, malaria and TB emerged during a period in which governments and multilateral agents came together to greatly expand access to medicine for these high-burden diseases — and to great effect. For example, 22 million lives have been saved through the Global Fund Partnership, a partnership of governments, the private sector and civil society.[1]

12 companies have eligible portfolio products falling under supranational agreements — Most of the products are medicines targeting HIV/AIDS.

By predicting the supply of medicines and vaccines, these practices have helped solved challenges relating to procurement and supply management including logistics to securing sufficient supply. Often, countries need to be eligible for support from these entities and the criteria for eligibility are based on income level, gross national income (GNI) per capita etc.

Twelve companies in scope have a total of 45 products procured via supranational agreements. Many of these products are vaccines and HIV/AIDS treatments which are generally bought by multilateral organisations, such as GAVI, the Vaccine Alliance or the Global Fund to fight AIDS, Tuberculosis and Malaria. The Index looked at whether companies offer the same terms of access for their products to countries which are not covered by these agreements.

Half of the companies offer the same terms of access to countries outside these agreements
Of the 12 companies that have eligible portfolio products falling under supranational agreements, only six companies (Bayer, GSK, Johnson & Johnson, MSD*, Novartis and Sanofi) offer the same terms of access to both eligible countries and non-eligible countries.

Only six companies offer the same terms of access to countries outside agreements — Bayer, GSK, Johnson & Johnson, MSD, Novartis and Sanofi offer the same terms of access to both eligible countries and non-eligible countries.

Which companies stand out?
The best performing companies in this area are Johnson & Johnson and Novartis. In fact, these companies offer the same terms to any non-eligible country for all the products assessed in this category. This is an important step for companies to facilitate access to these products in countries graduating from or not eligible for support from supranational organisations.

Seven companies (AbbVie, Bristol Myers Squibb, Boehringer Ingelheim, Gilead, Johnson & Johnson, MSD and Novartis) are taking additional steps to reach more patients across the income pyramid, by either applying non-exclusive licensing agreements, non-assert declarations, product donation programmes or offering the same price as the public sectors to NGOs serving lower-income households. Boehringer Ingelheim, GSK, Johnson & Johnson, Novartis, Pfizer and Sanofi expand patient reach for all their products assessed as part of these strategies.

Which companies facilitate access to countries outside supranational agreements? — Johnson & Johnson and Novartis offer the same terms to any non-eligible country for all the products assessed in this category.

Opportunity for companies to extend access terms to all products
Access strategies for supranationally procured products are generally better structured and applied more widely thanks to the presence of international organisations shaping the markets and the incentives already in place for the diseases targeted (HIV/AIDS, vaccines, malaria, tuberculosis etc.). Companies, however, can apply similar access terms to other products within their portfolio.

Please note: For this analysis, the Index analysed a sample of the companies’ portfolio products, looking at a maximum of five products per company.

*Merck & Co, Inc (Kenilworth, NJ USA)

[1] Global Fund. Global Fund Partnership has Saved 22 Million Lives - News & Stories - The Global Fund to Fight AIDS, Tuberculosis and Malaria. Published 2017. https://www.theglobalfund.org/en/news/2017-09-13-global-fund-partnership-has-saved-22-million-lives/ Accessed November 6, 2020.

Ending the burden of HIV, malaria and TB in children

This series of articles stress the urgent need for new “child-friendly” treatments for HIV, malaria and TB to end the burden these diseases have on children, especially with the looming impact of COVID-19 and emerging drug resistance.

What does access look like for healthcare practitioner-administered products?

This part three of a four part series, describes how medicines that need to be administered by a healthcare professional can face a number of access challenges in low- and middle-income countries. This analysis looks at whether companies tailor their access strategies for these products to reach a larger proportion of patients in these countries.

How we measure

The Index evaluates pharmaceutical companies in areas where they have the biggest potential and responsibility to make change, such as R&D and pricing. Find out more about the analytical framework and areas of evaluation.

A new, tighter analytical framework for 2021

The 2021 Access to Medicine Index is based on a new analytical framework of three Technical Areas, and 14 priority themes for corporate activity. Per area, companies’ policies and practices are measured by indicators that correspond to pharmaceutical companies’ core role for improving access to medicine. The new analytical framework for 2020 has a tighter structure, with 33 indicators grouped into three Technical Areas: Governance of Access, Research & Development and Product Delivery.

Analytical Framework for the 2021 Access to Medicine Index — The 2021 Access to Medicine Index analyses company behaviour using a framework of 33 indicators organised in three Technical Areas.

3 core areas of responsibility

A Governance of Access Looking at how companies govern, plan for and manage the achievement of access-linked objectives, while ensuring they apply processes that minimise the risk of non-compliant or corrupt behaviour occurring. It looks at access-to-medicine strategies, including whether they are aligned with corporate strategies, and how progress towards access to medicine objectives is measured and incentivised.

B Research & Development Looking at pharmaceutical companies R&D activities to develop or adapt products for the diseases,conditions and pathogens within the Index scope, and in response to the needs of people living in low- and middle-income countries. It also examines whether companies put plans in place during development to accelerate access to successful products for people living in low- and middle-income countries.

C Product Delivery Looking at 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. 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.

Distilling global priorities for access

Each Access to Medicine Index is the product of a two-year process known as the ‘Index cycle’, which begins with a review of the Index methodology. This process aligns the Index metrics with changes in access-to-medicine priorities and stakeholder consensus on what we expect from pharmaceutical companies to improve access to medicine. We also use the review to reaffirm the robustness of the next Index analysis, and ensure our capacity for trend analysis is maintained.

The latest review, held in 2020, led to the methodology for the 2022 Access to Medicine Index.

Do companies extend access terms for countries outside supranational agreements?

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