Performance in the 2024 Index
8th place. Boehringer Ingelheim ranks in the top ten. It has improved in Product Delivery, with a strong performance in capacity building. The company has an average performance in Governance of Access. It performs above average in Research & Development, where it has access plans for all projects.
Opportunities for Boehringer Ingelheim
Expand the depth and breadth of access plans for investigational compounds in the pipeline. Boehringer Ingelheim has access plans for all its late-stage R&D projects. For projects testing existing treatments in new indications, these plans are comprehensive and cover a broad range of countries. However, the depth and geographic coverage of access plans for investigational compounds are more limited. For example, it can expand its access plan for BI 1358894, an investigational compound in Phase II of development for major depressive disorder, to include more countries in scope of the Index.
Expand manufacturing capacity building efforts for medicines and vaccines. Boehringer Ingelheim and the Botswana Vaccine Institute have a partnership for the production and distribution of animal vaccines, including for rabies. To support the production of medicines and vaccines and build local manufacturing capabilities, the company can build on this initiative, pursuing similar collaborations in other countries in Africa for products prioritised for local production.
Expand access to essential medicines. Boehringer Ingelheim has access strategies in place for its products that are on the WHO Model List of Essential Medicines; however, the geographic reach of these strategies is mostly limited to upper-middle and lower-middle income countries. For example, the company can expand access to more countries in scope, particularly low-income countries for the products afatinib (Giotrif®/Gilotrif®), indicated for lung cancer, and alteplase (Actilyse®), for cardiovascular disease through equitable access strategies.
Changes since the 2022 Index
Announced plans to invest more than CNY 3.5bn (USD 438.25mn) into R&D efforts in China over the next five years.
Formed a joint venture (Aurobac Therapeutics SAS), together with Evotec SE and bioMérieux, to create the next generation of antimicrobials along with actionable diagnostics to fight AMR.
Reinforced public commitment to “Zero by 30”, the global goal to eliminate rabies by 2030. Expanded global STOP Rabies initiative, focusing on vaccination, education and surveillance, to additional countries in scope such as India, Indonesia and Vietnam.
Developed and implemented a new Access & Value policy that aims to provide broader and faster access for new, innovative assets.
Donated medicines to Afghanistan in response to aid requests from Americares in 2023.
Inaugurated its EUR 350mn biologicals development centre in Biberach an der Riss, Germany.
Developed and implemented a systematic approach to Human Rights and published several reports and statements.
Launched new “Access to Healthcare” initiative in Kenya.
Sales and Operations
Therapeutic areas: Cardiovascular and metabolic diseases, immunology, mental health, oncology, respiratory diseases, retinal diseases
Product categories: Animal health, innovative medicines
M&A news: In 2023, Boehringer Ingelheim acquired T3 Pharmaceuticals for CHF 450mn.
Net sales by segment (2023) – in EUR | |
Human pharmaceutical | 20.77 bn |
Animal health | 4.72 bn |
Other sales | 0.12 bn |
Total | 25.61bn |
Sample of pipeline and portfolio assessed by the Index
PIPELINE for diseases in scope
Boehringer Ingelheim has 22 R&D projects in scope, none of which target priority diseases. All 22 projects target other diseases in scope, including cancer (14), kidney diseases (3) and cardiovascular diseases (2). Of the 22 R&D projects, 7 are in late-stage development, with evidence of access planning for 100% (7/7) of these.
PORTFOLIO as selected for analysis by the Index
Boehringer Ingelheim has 20 products in scope, 11 of which are listed on the WHO EML. Of its 19 medicines, 14 are on patent, and all 19 target NCDs, including cardiovascular diseases (6), diabetes (6) and asthma and COPD (6). The company has 1 vector control product in scope for rabies.
Performance Breakdown
Governance of Access
Boehringer Ingelheim has an average performance in this Technical Area. The company provides evidence of a patient reach process that covers all countries and products in scope of the Index. However, it does not publicly provide the underlying methodology details, and no patient reach goals were identified. Boehringer Ingelheim sets individual-level sales targets for its sales agents, but it has a robust set of controls to mitigate the risk of non-compliant or corrupt activities in countries in scope.
The highest responsibility for access lies directly with the Board, specifically with the Board member responsible for Human Pharma. Boehringer Ingelheim has access-related incentives for senior executives and in-country managers.
Comprehensive access-to-medicine strategy integrated within the overall corporate strategy. Its strategy covers all therapeutic areas in which the company is involved. Boehringer Ingelheim publicly discloses its commitments to access to medicine, along with company-specific targets, goals and objectives. Reporting is mostly clear, linked to these goals, centrally available and updated regularly in its Annual Report.
Shows comparatively strong commitment to responsible business practices. Boehringer Ingelheim sets individual-level sales targets and incentives are not solely based on sales volume. Additionally, the company commits to ensuring ethical interactions with healthcare professionals in its code of conduct and declares that transfers of value to healthcare professionals (e.g., payments for attending events) are made at fair market value. However, it only publicly discloses information on such payments in countries in scope if required by law or local regulation.
Has robust set of controls to promote ethical conduct and mitigate risk to ensure that governance efforts are not undermined by noncompliant or corrupt activities. Boehringer Ingelheim performs strongly in this respect. It has policies to mitigate non-compliance risks, including processes to ensure third-party compliance with company standards, fraud-specific risk assessments and region or country risk-based assessments. It lacks a framework, but its code of conduct guides ethical employee decision-making. No breaches in countries in scope were found in the period of analysis.
Boehringer Ingelheim publicly supports the Doha Declaration on TRIPS and Public Health. It views the Declaration as a mechanism offering more juridical certainty to countries that may use the system. However, the company states that protecting intellectual property (IP) is the foundation for making long-term commitments to high-risk investment decisions in the research, development and commercialisation of innovative drug products.
Fulfils some criteria across 3 processes for measuring and reporting patient reach. For its global patient reach process covering all its products and all countries (where the company operates) in scope of the Index, Boehringer Ingelheim provided the underlying equation, metrics, assumptions and limitations directly to the Index. The resulting patient reach numbers are published regularly and demonstrate improvements. No associated patient reach and health outcomes goals were identified.
Research and Development
Boehringer Ingelheim performs above average in this Technical Area. It has an access planning framework from Phase II onwards and applies this to all late-stage pipeline candidates. The company does not have any priority projects in its pipeline, but it has comprehensive access plans for non-communicable disease projects – although the depth and breadth of plans vary depending on the project. Furthermore, it newly discloses public R&D investment data disaggregated by phase of development and has improved its R&D capacity building activities.
Structured process in place to develop access plans during R&D. The process is intended to be applied to all R&D projects in scope, no later than Phase II. The company does not make a public commitment addressing its systematic approach to access planning for LMICs.
Boehringer Ingelheim does not have any projects in its R&D pipeline targeting a priority disease in scope.
Average-sized pipeline, compared to peers, addressing other diseases in scope, with 100% (7/7) of late-stage projects covered by access plans. The company has 7 late-stage R&D projects targeting diseases in scope that have not been established as a priority by global health stakeholders. The projects mainly target cancer, kidney diseases and cardiovascular diseases. Boehringer Ingelheim provides evidence of access plans for all 7 late-stage projects, mostly focused on registration preparation and supply and demand plans.
Boehringer Ingelheim publicly discloses disaggregated R&D investment data for phase of development. However, it does not disclose disaggregated R&D investment data to global health organisations.*
Three of the four R&D capacity building initiatives included for analysis meet all Good Practice Standards (GPS). One example is a collaborative training initiative with local hospitals and universities in Brazil, focused on patient safety and pharmacovigilance. Similar programmes are being implemented in Nigeria and Kenya.
*Boehringer Ingelheim currently has no pipeline candidates within the disease scope of Impact Global Health (formerly known as Policy Cures Research), an organisation that assesses disaggregated R&D data.
Product Delivery
Boehringer Ingelheim performs above average in this Technical Area, showing significant improvement since the last Index. The company has a comprehensive strategy to provide access to its supranationally procured product. It also implements comprehensive access strategies for its products and generally reports their outcomes, however coverage in low-income countries is limited. The company engages in multiple new intellectual property sharing agreements. Most of its capacity building initiatives across supply chain, manufacturing and health system strengthening, meet all Good Practice Standards.
Boehringer Ingelheim registers products in 23 countries in scope on average. It registers 80% of products assessed in at least 1 of the 10 countries with the highest disease burden; however, only 30% are registered in LICs. The company’s empagliflozin (Jardiance®), licensed for multiple indications including diabetes mellitus, is most widely registered, totalling 43 countries in scope. The company did not report participating in any mechanisms to facilitate registration.
Has access strategies for its supranationally procured product in scope. Boehringer Ingelheim supplies its veterinary rabies vaccine (Rabisin®) through the Pan American Health Organization (PAHO). The company also demonstrates access strategies for the product in a country not eligible for procurement via PAHO. In Vietnam, the company engages in supply chain strengthening and capacity building initiatives, as well as in vaccination campaign and product donations. The company shares evidence of the strategy outcomes and plans to progress the strategy with a comprehensive goal aimed at eliminating rabies.
Access strategies for healthcare practitioner (HCP)-administered products in some countries, with outcomes tracked and reported. For both products selected for analysis, Boehringer Ingelheim provides evidence of access strategies in UMICs and LMICs, but not in any LICs. Access strategies in UMICs are more comprehensive. For example, in Mexico (UMIC), for its product tenecteplase (Metalyse®), indicated for cardiovascular disease, the company implements tailored cost-effectiveness models and budget impact analysis with the different public health institutions and the product is fully reimbursed for patients in the public sector. The second product analysed, also indicated for cardiovascular disease, is publicly reimbursed in both the UMIC and LMIC examples. The company engages in health system strengthening initiatives; for example, through the Angels Initiative, it supports the improvement of a stroke management system in Egypt (LMIC). The company has goals to increase access to its products and reported outcomes data, including patient reach for all the examples assessed.
Access strategies for its self-administered products in some countries, with outcomes mostly tracked and reported. For 2 of the 5 products selected for analysis, Boehringer Ingelheim provides access strategy examples in all 3 country income classifications (UMIC, LMIC, LIC); 3 products lack access strategies in LICs. The company demonstrates efforts in reaching patients across income levels through its strategies in UMICs and LMICs. In Mexico (UMIC), the company launched a generic brand of telmisartan/hydrochlorothiazide (Micardis Plus®), supplied through a local partner, Farmacias Similares, to improve affordability for low-income populations; it plans to do the same for a second product. In Kenya (LMIC), 3 of the 5 products analysed are part of the Access to Healthcare (AtH) programme, through which the price is determined based on individual income levels and eligibility assessed by a third-party survey. For all UMIC and LMIC examples analysed, strategies’ outcomes are tracked and reported, although for those under the AtH programme this is at an aggregated level.
Boehringer Ingelheim publicly commits not to file for or enforce patents for all products in the majority of countries in scope. This applies to all products in all LICs, least developed countries and many LMICs and UMICs. The list of countries to which the commitment applies is publicly available.
Boehringer Ingelheim does not publish patent information of its products on its website or via a patent database, such as Pat-INFORMED.
Boehringer Ingelheim does not engage in non-exclusive voluntary licensing for products in scope.
All 5 manufacturing capacity building initiatives included for analysis meet all GPS. For example, Boehringer Ingelheim has partnered with the Botswana Vaccine Institute (BVI) since 1978, transferring technology for animal vaccine production. BVI is currently a distributor for the company's veterinary rabies vaccine (Rabisin®) in sub-Saharan Africa.
Three of the five supply chain capacity building initiatives included for analysis meet all GPS. For example, Boehringer Ingelheim supports Wella health, a digital platform connected with nearly 2,000 pharmacies in Nigeria that aims to address availability, affordability and adherence to treatment.
All 5 health system strengthening initiatives included for analysis meet all GPS. For example, in partnership with major stroke organisations, Boehringer Ingelheim's Angels Initiative aims to improve global stroke care by increasing the number of hospitals able to provide quality stroke care in more than 150 countries including 70 countries in scope.
Boehringer Ingelheim newly engaged in 26 IP-sharing agreements with public research institutions to accelerate drug development. The company performs well in this area. Through opnMe.com Boehringer Ingelheim shares molecules with partners, such as São Paulo State University, Brazil to accelerate preclinical research for diabetes, mental health conditions and communicable diseases, such as malaria and COVID-19. The company also remains engaged in existing agreements.
Fulfils all criteria for ad hoc donations. Boehringer Ingelheim has public policies and supply processes to carry out ad hoc donations rapidly in response to expressed need, with delivery monitored to ensure donations reach patients. For example, in 2023, The Boehringer Ingelheim Cares Foundation (BICF) responded to aid requests from Americares by donating medicines to Afghanistan. This comprised 3 products, including empagliflozin (Jardiance®), which is in scope, reaching 524 patients. BICF publicly commits to adhering to the most recent WHO Guidelines for Medicine Donations.
Boehringer Ingelheim publicly commits to continue long-term donation programme to support the elimination of human dog-mediated rabies. Its programme is active in 9 countries in scope, with the company pledging to donate its rabies vaccine (Rabisin®) to help ensure there are no human deaths from dog-mediated rabies by 2030.
Fulfils all criteria for mechanisms to ensure continuous supply in LMICs. For example, Boehringer Ingelheim is working with Algeria's Abdi Ibrahim Remede Pharma to manufacture the antihypertensive telmisartan/hydrochlorothiazide (Micardis Plus®) and package the diabetes treatment empagliflozin (Jardiance®) for local supply.
Boehringer Ingelheim has a policy for reporting substandard and falsified medicines in countries in scope. It reports cases to national or local regulatory authorities within 7 days. The company discloses to the Index, but not publicly, whether it has shortened reporting timeframes for cases that only require visual inspection for confirmation.
Boehringer Ingelheim operates an inclusive business model that covers 2 products in 1 country. Launched in 2014, the model is a partnership with Farmacias Similares in Mexico, providing reduced cost antihypertensives telmisartan (Micardis®) and telmisartan/ hydrochlorothiazide (Micardis Plus®) to low-income populations. Additionally, diabetes treatments are planned to be launched. The company also offers healthcare worker training to improve care in the public and private sector.