Ensuring that people worldwide benefit from the efforts of the pharma industry is critical for achieving the Sustainable Development Goals (SDGs) by the UN’s deadline of 2030. A coordinated approach between all stakeholders is needed to address chronic issues, including low transparency, which can slow the pace toward achieving universal health coverage (UHC). When it comes to transparency and access to medicine, the main areas where improvement is needed relate to the practices of the pharmaceutical industry, particularly around R&D costs, marketing costs and their relationship with drug prices.
Access to medicine is a material issue for pharmaceutical companies, bringing a range of material risks and opportunities to investors in pharmaceutical companies. This is reflected in many recent materiality assessments, as well as articles illustrating increasing investor demand for a better response from the industry on global health issues: e.g., from Achmea and others; from ICCR; and from Legal & General Investment Management and AXA Investment Managers.
The world is demanding better access to medicine for people living in low- and middle-income countries and for industry to address global threats such as pandemics and the rise of antimicrobial resistance (AMR). Pharmaceutical companies’ role in this is clear: to conduct R&D for dangerous and burdensome diseases, such as emerging infectious diseases, and develop better treatments for chronic diseases, such as cancer and diabetes; to increase the availability, affordability and accessibility of medicines and vaccines so that people living all over the world can benefit; and to do so responsibly. This role applies to all levels of a pharmaceutical company, from the Board of Directors and CEO, to local teams driving access to medicine in-country.
Transparency that drives access
Information is a tool and a catalyst – which can unleash the power of other organisations active in the field to adapt, develop and deploy new initiatives for improving access to medicine. Through their activities, pharmaceutical companies generate a wealth of information and data that can be put to use by people and governments of low- and middle-income countries (LMICs) and by multilateral organisations working toward UHC – from information on how companies address affordability and pricing, to which projects are in the pipeline, to plans to ensure responsible management of intellectual property.
For example, as reported in the 2020 Antimicrobial Resistance Benchmark, nine companies shared the results of AMR surveillance programmes in open-access journals or via data platforms, with one company even sharing its raw data publicly. Such programmes monitor the prevalence of drug-resistant infections and effectiveness of medicinal treatment. Transparency about results provides government officials and healthcare professionals with insights that lead to better treatment choices.
Further, since the 2018 launch of Pat-INFORMED, an online platform to disclose per-country patent status of small molecules, 21 companies have joined and share information on patents they hold and when and where they expire. The platform aims to simplify complex patent language. Such information can be used for the more efficient procurement of essential medicines and thereby support better health outcomes for people across the globe.
Which information best enables Universal Health Coverage and access to medicine?
- Intellectual Property strategy, such as plans not to file and/or enforce patents patent status information and scopes of non-exclusive voluntary licences
- Equitable pricing strategies, across markets including how affordability is addressed for poorer populations
- R&D pipelines and access and stewardship plans for these projects
- Data on compound libraries, studies of efficacy and safety and technology that can enable research and manufacturers
- Clinical trial information and outcomes
Information sharing inspires use of best practices
Transparency about how companies develop and deploy strategies and initiatives is also directly useful for other organisations to improve access to medicine. Such insight enables peers to replicate good practice, and to develop partnerships to build on these practices and further improve them. It also enables accountability and evaluation by independent organisations. Every two years, the Access to Medicine Index identifies best practices in specific areas of pharma company activity. In the 2018 Index, data disclosure by pharma companies led to the identification of 45 best and innovative practices for improving access to medicine: such as enhanced mobile technology platforms that track medicine and vaccine stock data in remote locations of Cameroon, Mozambique, Nigeria, Pakistan, Tanzania and Zambia. These platforms strengthen accountability for medical inventory and enable companies and local stakeholders to work together to adjust to improve the situation at scale.
Fuelling trust and motivating employees
Greater transparency brings direct benefits to pharmaceutical companies. Openness supports recruitment and the retention of committed colleagues. It builds trust, enables accountability, improves alignment with stakeholders, and can lead to new solutions. Tens of thousands of people at pharmaceutical companies come to work every day to get health products to the people who need them, wherever they live. Transparency gives recognition to these people for their work. When delivered across the industry, transparency provides talented employees and peer companies with the fuel to develop urgently needed new solutions to chronic access-to-medicine challenges. When pharmaceutical companies expand their information-sharing efforts to match the needs of society, they can look good by doing good.
Who is asking for transparency?
Global health stakeholders call for greater transparency of specific information needed to improve access to medicine. In May of 2019, the World Health Assembly approved a resolution to support greater public disclosure of prices and R&D costs for medicines and other health products.
Preparing and sharing large datasets is also work – it requires time, people and other resources to do carefully, in the right way. For companies, it can be a challenge to keep central oversight of their myriad access activities. Pricing strategies, patents and licensing are often centrally organised, whereas on-the-ground initiatives, such as patient-reach and capacity building activities are run by country teams. Keeping this information organised, up to date and in a central place requires effort, but this should not be a barrier, especially where the benefits to society are so well understood.
There is an expanding field of research organisations and data providers approaching pharmaceutical companies with requests for information on specific topics, often related to Environmental, Social, Governance factors. These requests touch many areas of business: those where transparency is driven by regulation, as well as where companies determine how much to share. The perception of competitive risk also limits information sharing, such as about detailed pricing strategies or on early-stage pipeline candidates.
Consensus on transparency that makes a difference
When it comes to information disclosure, the devil is in the details and pharmaceutical companies cannot reasonably be expected to satisfy all demands for data. Every two years since 2008, the Access to Medicine Foundation has engaged with people from the global health, industry and investment worlds to clarify what information on access to medicine in low- and middle-income countries is most useful to outside partners, how it can best be shared – and why disclosure matters. The Access to Medicine Foundation builds this consensus view through discussions with investors, universities, industry, governments, and other research organisations with whom we align methodologies for evaluating pharma companies’ performances. Independent evaluations, such as the Access to Medicine Index, show how far companies are going to meet society’s expectations for good practice, and provide outside perspective on how companies compare with each other and against consensus-based metrics. By creating forums and connections where knowledge and insight can be shared, the Foundation stimulates pharmaceutical companies to improve their performances.