RANKINGS & ASSESSMENTS

2026 Access to Medicine Index

Now in its tenth edition, the 2026 Access to Medicine Index marks 20 years of tracking pharmaceutical industry action on global health equity. It ranks 20 of the world’s largest pharmaceutical companies on their efforts to expand access to essential healthcare products in low- and middle-income countries. Individual company Report Cards assess performance against key access-to-medicine priorities and highlight areas for improvement.

Explore in detail how the pharmaceutical companies perform on Access to Medicine Index and AMR Benchmark

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Access to Medicine Index
AMR Benchmark

1 1	Novartis AG	0 1 2 3 4 5	3.86
2 2	GSK plc	0 1 2 3 4 5	3.73
3 5	AstraZeneca plc	0 1 2 3 4 5	3.28
4 3	Sanofi	0 1 2 3 4 5	3.17
5 10	Bayer AG	0 1 2 3 4 5	3.15
6 8	Boehringer Ingelheim	0 1 2 3 4 5	3.11
6 11	Roche Holding AG	0 1 2 3 4 5	3.11
8 4	Pfizer Inc	0 1 2 3 4 5	2.96
9 7	Merck KGaA	0 1 2 3 4 5	2.81
10 9	Takeda Pharmaceutical Co, Ltd	0 1 2 3 4 5	2.72
11 12	Novo Nordisk A/S	0 1 2 3 4 5	2.67
12 13	Bristol Myers Squibb	0 1 2 3 4 5	2.34
13 5	Johnson & Johnson	0 1 2 3 4 5	2.26
14 14	Eisai Co, Ltd	0 1 2 3 4 5	2.25
15 16	Merck & Co, Inc	0 1 2 3 4 5	2.14
16 16	Gilead Sciences	0 1 2 3 4 5	2.03
17 15	Astellas Pharma Inc	0 1 2 3 4 5	1.67
18 19	Eli Lilly & Co	0 1 2 3 4 5	1.66
19 18	Daiichi Sankyo Co, Ltd	0 1 2 3 4 5	1.65
20 20	AbbVie Inc	0 1 2 3 4 5	1.29
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2026 Access to Medicine Index

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Insights

Novartis retains top spot, with GSK close behind

Novartis takes 1^st place for the second time, followed closely by GSK. AstraZeneca joins the top three, while Bayer and Roche are the biggest risers, each climbing five places. Bayer enters the top five, and Roche joins Boehringer Ingelheim in joint 6^th place.

Find out how companies compare

Report Cards highlight next steps

Each company’s Report Card provides a detailed overview of its performance in the 2026 Index, including a summary of its strengths and weaknesses, drivers behind changes in its ranking, as well as tailored Opportunities to improve and maximise its access-to-medicine efforts.

View the companies' Report Cards

20 years of the Index

The 2026 Index marks ten editions of tracking and catalysing progress in access to medicine. This milestone edition includes a unique lookback analysis examining two decades of change in the pharmaceutical industry and in how companies approach access to medicine. Tracing this transformation alongside the evolution of the Index itself, the analysis reveals a clear and promising shift: access to medicine has moved from the fringes of company operations to become an increasingly integral part of how companies do business.

Read about how the industry has evolved

Best Practices with potential for wider impact

The 2026 Access to Medicine Index has identified five Best Practices across the three Technical Areas: one in Governance of Access, two in Research & Development and two in Product Delivery. The selection focuses on practices with the potential to improve access more widely if adopted by other companies.

Read the Best Practices from 2026 Access to Medicine Index

CEO Jayasree K. Iyer's take on the Index

Two decades of progress, a defining moment for access

Novartis and GSK lead across all three Technical Areas

Novartis ranks 1st and GSK 2^nd in the 2026 Index, both overall and in each of the three Technical Areas: Governance of Access, Research & Development (R&D) and Product Delivery. Novartis has robust governance structures in place and demonstrates Best Practice in measuring patient reach through its systematic approach and transparent reporting. Its comprehensive access strategies span different product categories, supporting its leading position in Product Delivery. In R&D, Novartis combines a diverse pipeline with consistently strong access planning across its late-stage projects.

GSK demonstrates strong performance across the board, with robust governance structures and a systematic approach to measuring patient reach. Its priority pipeline remains the largest among its peers and spans a range of infectious diseases. Further strengths include voluntary licensing and capacity-building initiatives.

Six high-performing companies follow the leaders

Six companies perform above average across all three Technical Areas. AstraZeneca (3^rd) rises two places, supported by the largest research and development pipeline for diseases outside the Index’s priority disease scope alongside access plans that stand out for their breadth and depth. Sanofi (4^th) demonstrates Best Practice in reporting on its inclusive business model (IBM) and has comprehensive access strategies for self-administered products.

Bayer (5th) rises five places, driven by improvements across all three Technical Areas. Its Global Health Unit is newly assessed as an IBM in the 2026 Index. With a strong focus on non-communicable diseases, Boehringer Ingelheim rises two places to joint 6th alongside Roche, demonstrating strength in access strategies and capacity building. Roche also climbs five places, supported by the geographic breadth of its access planning for cancer products and improved performance in Governance of Access. Pfizer (8th) falls four places, with gaps in reporting access strategy outcomes, but demonstrates Best Practice in access planning for neonatal health.

Moderate-performing companies

Merck KGaA (9th) performs moderately in all Technical Areas, with a smaller priority pipeline contributing to its decline in Research & Development and gaps remaining in access strategies for some cancer products in low-income countries. Takeda (10^th) demonstrates Best Practice in vaccine access but has no pipeline addressing priority diseases and shows mixed performance in access planning. Novo Nordisk (11th) registers newer products in more countries than peers on average, with evidence of registration in low-income countries for all products assessed. Bristol Myers Squibb (12th) addresses broader barriers to cancer care, but registers newer products in fewer countries than peers on average.

Johnson & Johnson (13th) falls eight places, reflecting a smaller priority pipeline and limited reporting on patient reach, product registration and access strategies. Eisai (14th) registers products in more countries than peers on average, but has limited access planning across its pipeline. MSD (15th) and Gilead (16th) both use voluntary licensing to expand access to their products, but reporting on access strategies and their outcomes remains limited.

Low-performing companies

Astellas (17^th) has robust anti-corruption controls, but is the lowest performer in Research & Development, where it does not report access plans for late-stage projects. Eli Lilly and Company (18^th) has access plans for most late-stage projects, but evidence is limited to a public commitment to register products in countries where it conducts clinical trials.

Daiichi Sankyo (19th) has expanded access to some cancer treatments through broader registration and partnerships, although it has a reduced priority pipeline and limited outcome reporting for access strategies. AbbVie (20th) performs poorly across all Technical Areas, although it now discloses a company-wide patient reach metric.

How companies were assessed in the 2026 Index

The 2026 Access to Medicine Index assesses 20 of the world’s largest research-based pharmaceutical companies in relation to 113 low- and middle-income countries. The country scope is unchanged from 2024, while the disease scope has expanded to 84 diseases, conditions and pathogens.

Companies are assessed against 29 indicators across three Technical Areas, each weighted differently in the overall Index score: Governance of Access (15%), Research & Development (30%) and Product Delivery (55%). Three indicators, one in each Technical Area, have been retired after fulfilling their intended purposes. The updated methodology for the Index places greater emphasis on implementation and measurable progress, including how companies track and report patient reach.