Big Pharma is losing sight of the world’s poorest patients

Drawing on key findings from the 2026 Access to Medicine Index, it highlights how access has become more firmly embedded in pharmaceutical companies’ business strategies, with 68% of late-stage drug candidates now covered by access plans, more than three times the proportion in 2018. Novartis retained first place in the Index, while Roche rose to sixth, tied with Boehringer Ingelheim.

The article also highlights persistent gaps between access planning and implementation, including declining investment in neglected tropical diseases, the concentration of research in more commercially attractive areas, and the continued affordability challenges facing patients. It explores how voluntary licensing could expand access to medicines, citing recent agreements by Roche and Novartis, while noting that uptake across the industry remains limited. The article further considers how US trade pressure and companies’ focus on protecting their largest market could affect global pricing and access strategies.  

Access to Medicine Foundation CEO Jayasree K. Iyer is quoted reflecting on the progress made over the past two decades, while warning that industry performance has plateaued: “We are at a pivot point as an industry. You have to make a choice,” Iyer said. “Are you going to develop your growth in emerging markets and developing countries where the demand is growing, or are you going to react in the way you’ve always done by trying to hold on to the small number of markets that have been carrying your business up to now?”