What is the Access to Medicine Index?
The Access to Medicine Index 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.
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 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 Access to Medicine 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 Access to Medicine 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 Access to Medicine 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 Access to Medicine 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 Access to Medicine 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?
The Index is a relative ranking, where companies are compared with each other rather than against an absolute, ideal state. 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 Access to Medicine 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.
The Frequently Asked Questions mentioned below refer to the 10-year analysis "Are pharmaceutical companies making progress when it comes to global health?"
What is the “10-year analysis”?
The 10-year analysis “Are pharmaceutical companies making progress when it comes to global health?” is the first independent report that shows where pharmaceutical companies have made progress in the past ten years when it comes to access to medicine. It covers 20 of the world’s largest research-based pharmaceutical companies, which the Access to Medicine Foundation has tracked since 2008 in the Access to Medicine Index.
When was the 10-year analysis published?
The report was published on Thursday 16 May, 2019 on the website of the Access to Medicine Foundation.
What is the scope of this report?
The 10-year analysis covers: (a) areas where pharmaceutical companies have a clear role and responsibility to act; and (b) where action by pharmaceutical companies is critical for improving access to medicine. This includes research and development (R&D), as well as pricing, licensing and registering products for sale in countries in need. Its findings cover 106 low- and middle-income countries – home to 83% of all people alive today – and the 47 diseases and conditions that have been consistently covered by the Index since 2014. Each analysis goes back as far as data permit, with 2008 as the earliest possible year.
Which companies are covered in this report?
The 10-year analysis covers 20 of the world’s largest research-based pharmaceutical companies, which together account for 70% of global pharmaceutical revenues. They include highly diversified companies, such as GSK, Pfizer, Novartis and Sanofi, which all have large generics divisions. Several companies with a narrower focus, such as Gilead and Novo Nordisk, are also included in the cohort. These companies have been tracked in the Access to Medicine Index since 2008.
All companies covered in the analysis: AbbVie Inc., Astellas Pharma Inc., AstraZeneca plc, Bayer AG, Boehringer Ingelheim GmbH, Bristol-Myers Squibb Co., Daiichi Sankyo Co. Ltd., Eisai Co. Ltd., Eli Lilly & Co., Gilead Sciences Inc., GlaxoSmithKline plc, Johnson & Johnson, Merck & Co., Inc., Merck KGaA, Novartis AG, Novo Nordisk A/S, Pfizer Inc., Roche Holding AG, Sanofi and Takeda Pharmaceutical Co. Ltd.
Does the report assess how individual companies have progressed over time?
No – it assesses the level of progress across the industry in order to spark discussions about system-level improvements that can be made. The 2018 Access to Medicine Index covers changes per company since the previous Index and identifies specific opportunities for change company by company.
What were the sources of this report?
The data for this report have been independently collected and analysed by the Access to Medicine Foundation. Much of the data were gathered for the Access to Medicine Index, which has been published every two years since 2008. The specifics of the methodology used for the report are covered in the Appendix.
How can this report be used, for example by pharmaceutical companies?
The 10-year analysis looks ahead to 2030 and the achievement of SDG 3 to explore how the pharmaceutical industry can sustain and build on the progress made to date. Individual companies and coalitions can use the findings of this report to prepare for the next decade, for example, by taking stock of what has been achieved over the past decade in order to refine their approach, learn from best practice and scale up good practice to more products, countries and people.
I would like to comment on the report. How can I best do this?
The report aims to provide a springboard for discussions on how the progress to date on access to medicine can be expanded across the industry in order to achieve SDG 3 by 2030. Please send any comments you have about this report to dedwards@accesstomedicinefoundation.org.