GSK leads, followed closely by Pfizer and Johnson & Johnson. Shionogi has moved up to third, in front of Novartis and Otsuka. GSK leads in all Research Areas, despite regressing in certain metrics. It has the largest pipeline (27 projects), including the bulk of new vaccines being developed. Most of its late-stage candidates are protected by plans to ensure better access and good stewardship soon after launch. GSK discloses multiple strategies to ensure a continuous supply of antibacterials to countries where they are most needed.* These include dual sourcing for active pharmaceutical ingredients (APIs) and maintaining safety stocks. However, GSK has stepped back from fully decoupling its sales agents’ bonuses from sales volumes. It has also not fulfilled its 2018 pledge to share its raw data from resistance surveillance.
Pfizer rises to second place. It is now leading across the stewardship metrics, and is the first pharmaceutical company to publicly share raw surveillance data from its ATLAS programme. After GSK, it has one of the larger vaccine pipelines, developing an improved pneumonia vaccine, as well as new clinical-stage vaccines for C. difficile, Group B Streptococcus.
Johnson & Johnson maintains a comparatively strong performance, with a focus on tuberculosis, as in 2018. For example, in stewardship, Johnson & Johnson engages in several tuberculosis-related educational programmes for healthcare professionals, taking action to mitigate conflict of interest. It also supports surveillance programmes for tuberculosis, sharing data with public health authorities.
Shionogi rises up, and invests the highest proportion of its pharmaceutical revenues in relevant R&D: USD 133 million in 2017 and 2018. It is developing several medicines that target some of the most dangerous drug-resistant pathogens.** Shionogi runs multiple AMR surveillance programmes, including one that tracks resistance of Gram-negative bacteria in 13 countries. It is the only large-research-based pharmaceutical company evaluated that fully decouples incentives for sales agents from sales volumes to help prevent the inappropriate use of all its antibacterials. Its antibacterial cefiderocol gained marketing approval in November 2019.
Since 2018, Novartis and Sanofi have licensed out or otherwise divested antimicrobial R&D assets, which contributes to their weaker performances since 2018. Both companies report a comprehensive strategy to minimise the environmental impact of wastewaters and solid waste from antibacterial manufacturing at their sites, with an aim to limit AMR. Novartis reports that, including via Sandoz, it processes more than 50 antibacterial APIs across a network of 21-40 sites, and works with more than 100 suppliers of products. Merck & Co, Inc has the second largest pipeline in the Benchmark, including antibacterial and antifungal medicines, as well as vaccines projects. The company launched a new antibiotic in July 2019, targeting carbapenem-resistant Enterobacteriaceae.