A research programme by the Access to Medicine Foundation

Frequently Asked Questions

Who makes the Access to Medicine Index? 
The Index is produced and published by the Access to Medicine Foundation, an international non-profit organisation. The Foundation's mission is to stimulate and guide pharmaceutical companies to do more for people living in low- and middle-income countries without access to medicine. The Foundation has published the Access to Medicine Index every two years since 2008. It published the first Access to Vaccines Index in 2017, followed by the first Antimicrobial Resistance Benchmark in January 2018.

What is the Access to Medicine Index? 
It ranks 20 of the world's largest research-based pharmaceutical companies in how they improve access to medicine, vaccines and diagnostics in 106 low- to middle-income countries, using 69 metrics, and covering 77 diseases, conditions and pathogens. It has been published every two years since 2008. It is independently funded by the UK and Dutch governments and the Bill & Melinda Gates Foundation.

What is the aim of the Access to Medicine Index? How does it change pharmaceutical companies?
The Index is a tool for driving change in the pharmaceutical industry. It identifies best practice, tracks progress and shows where critical action is needed to improve access to medicine for the poor. It provides companies with a transparent means by which they can assess, monitor and improve their own performance and their public and investment profiles.

Why does the Access to Medicine Index focus on pharmaceutical companies? 
Considering their size, resources, pipelines, portfolios and global reach, large pharmaceutical companies have a critical role to play in improving access to medicine. The Access to Medicine Index was established with two aims: first to define a clear list of what pharmaceutical companies can and should be doing to improve access; and second to spur companies to compete to perform best against this list of expectations. Before the Index, there was no clear path for pharmaceutical companies to follow in improving access to medicine. The 20 companies in the Index account for around 70% of global pharmaceutical revenues. 

Are pharmaceutical companies solely responsible for addressing access to medicine?
The access to medicine challenge is multi-faceted and many different actors must take responsibility. This includes the scientific research community, local governments, public health and regulatory agencies, overseas development agencies, philanthropists, trade administrators, the non-profit sector including product development partnerships, and both the research-based pharmaceutical companies and manufacturers of generic medicines. Pharmaceutical companies, with the resources and the knowledge to develop medicines, have a responsibility to ensure these technologies are made available to people, regardless of their socioeconomic standing. Improving access to medicine creates new routes to market, opening up demand for new and adapted products. As companies enter new markets, they must do so ethically and responsibly.

What does the Index measure? 
The Access to Medicine Index uses a weighted analytical framework of 69 indicators to capture and compare company action in 106 low-and middle-income countries and 77 diseases, conditions and pathogens. This includes deadly infectious diseases such as malaria, HIV/AIDS and tuberculosis, as well as many lifestyle-linked diseases, such as heart disease, diabetes and respiratory diseases. The framework is constructed along seven areas of focus, which cover the range of company activities that experts consider most relevant to access to medicine: management, compliance, R&D, pricing, patents, capacity building and donations.

How were the 20 companies selected? 
The Index analyses 20 of the world’s largest research-based pharmaceutical companies. They are selected based on their size, market capitalisation and the relevance of their product portfolio and pipeline. 

How was the data collected and verified? 
To make the Index, the Foundation's research team analyses data from public sources and collected via a detailed survey of pharmaceutical companies regarding their policies and practices on access to medicine. Sources include the US FDA, the European Medicines Agency, Health Canada, ClinicalTrials.gov, MedsPal, LexisNexis, annual filings and reports from companies, among others. Data submitted by companies is verified, cross-checked and clarified by the research team using public sources and supporting documentation provided by the companies.

Does the data reflect a set time period? 
The 2018 Index includes relevant data from 1 June 2016 to 31 May 2018. 

Who conducted the analysis?
The data-collection, analysis and scoring was completed in-house by a dedicated research team. The Research Programme Manager for the Index is Danny Edwards. Key sections of the report were submitted by the Foundation for peer reviews by independent experts, including members of the Expert Review Committee (ERC) for the Index. The report was also reviewed by the Chair of the ERC.

How was the methodology for the Index developed? 
The Index is the product of a rigorous methodology that is aligned every two years with new developments in access to medicine. The review for the 2018 Index began in early 2017 and included a series of internal checks on indicators, data sets and analytical approaches. Methodology proposals were informed by input from experts working across the access-to-medicine field through a wide-ranging multi-stakeholder dialogue coordinated by the Access to Medicine Foundation.

How can my organisation contribute to the methodology development of the next Access to Medicine Index?
Every two years, we carry out a targeted review of how stakeholders view pharma’s role in access to medicine. We engage with specialists from multilateral organisations, governments, research institutions, the pharma industry, NGOs, patient organisations and investors. These activities follow set timelines. If you would like to contribute, please get in touch.

Can you compare the 2018 Index to previous Indices? 
As a result, a direct longitudinal analysis, indicator by indicator, is not possible. This is due to changes over time in the data collected and the methods used to either verify, compare or otherwise analyse them. In our reporting, where we make a statement about change over time, we conduct specific analyses of the original data to ensure a comparison is possible. 

How is the Index funded? 
The Index has been independently developed by the Access to Medicine Foundation, using funding from the the UK's Department for International Development, the Bill & Melinda Gates Foundation, and the Netherlands' Ministry of Foreign Affairs. The Foundation is an independent non-profit organisation. 

Why is access to medicine a global issue?
The UN has estimated that two billion people worldwide lack access to diagnostics, vaccines and treatments because they are unaffordable, unaccessible or unavailable in their country. The constitution of the World Health Organization asserts that all people have the right to the highest attainable standard of health.


Learn more

View our detailed overview of each company’s performance in the Index, including breakdowns of their product portfolios and R&D pipelines.