How do companies ensure worldwide access to their products?
This part one of a four part series, describes how the Index assessed whether companies tailor their access strategies to reach patients across the income pyramid and how they overcome-specific access barriers.
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
Strategies with the biggest potential impact for access
Ultimately, affordability depends on who is paying and the constraints they face. This is why pharmaceutical companies must think in terms of who is going to pay. This can range from government-run health systems to patients paying out of pocket right across the income pyramid – including those at the very base.
Access strategies with the biggest potential impact on access to medicine are strategies that aim to make products affordable for all patients across the income pyramid. Yet, there is no ‘one-size-fits-all-products’ approach to access to medicine. How companies consider access can depend on the product. For example, medicines that need to be administered by a healthcare professional can face a number of diverse access challenges in low- and middle-income countries — particularly in weaker healthcare systems where there may be poor infrastructure and patchy health services.
In general, companies can use three main access strategies to increase access to medicine in countries in scope:
Equitable pricing strategies: Setting prices within the ability of specific populations to pay, with reference to a range of socioeconomic factors;
Responsible intellectual property (IP) management: Licensing agreements under pro-access terms and/or pledges not to enforce patents to facilitate generic entry; and
Product donations: Identifying populations with no capacity to pay for the new product and donating products as appropriate in collaboration with local partners.
What sample of products did the Index assess?
To see how companies tailor their access strategies to reach a larger proportion of the income pyramid and how they overcome barriers when dealing with different products, the Index looked at three different categories of products:
- Supranationally procured products: Products linked to international pooled procurement, market-shaping facilities and significant public funding and donor support, such as vaccines.
- Healthcare practitioner (HCP)-administered products**: Products that often require either hospital administration of the product or the attention of a skilled healthcare professional during administration such as IV-administered cancer treatments.
- Self-administered products**: Products that can be administered by the individual patient, including treatments for diabetes and heart disease.
For each category, the Index analysed a sample of a maximum of five products per company, resulting in a total of 199 medicines and vaccines that are considered essential for a well-functioning healthcare system and for which large companies hold a controlling position regarding access – determined either through patents or their dominance of the market.
For this analysis, the Index analysed a sample of the companies’ portfolio products, looking at a maximum of five products per company.
* Based on the definition used by: Business Call to Action. Implementing Inclusive Business Models. How Business Can Work With Low-Income Communities.; 2015. https://www.unglobalcompact.org/library/3161. Accessed December 18, 2020.
** Weak access strategies with a low performance score were not included in this analysis. For a fine grained view of individual company access strategies, see the Report Cards.