Performance by Technical Area

Has a strong access-to-medicine strategy with board-level responsibility. AstraZeneca is one of 14 companies that performs strongly with regard to its access-to-medicine strategy, which includes access-related goals and aligns with its corporate strategies. The company aims to take a commercially sustainable approach to access. The strategy centres around expanding disease prevention, awareness, treatment and capacity building in areas with limited infrastructure. The highest level of responsibility for access sits with a board member.

Non-financial access-related incentives in place for employees. AstraZeneca has non-financial incentives in place to motivate employees to perform on access-related issues. These incentives are centred around providing a good working environment and delivering on performance.

Measures and monitors outcomes and progress; not impact. AstraZeneca measures and monitors progress and outcomes of access-to-medicine activities. It also publicly reports on commitments, targets and performance information. For example, the company reports a target of reaching 25 million patients by 2025 through a variety of Health Systems Development programmes. However, it does not report measuring the impact of its initiatives.

Some transparency about stakeholder engagement. AstraZeneca publicly discloses which stakeholder groups it engages with on access issues, but does not publicly share its process for selecting who to engage with. Neither does it report on how it incorporates local stakeholder perspectives into the development of its access strategies. However, AstraZeneca publicly shares a specific policy for ensuring responsible engagement — in order to strengthen transparency and multi-stakeholder engagement (including with patient groups and other healthcare organisations aimed at improving patients' lives) and comply with local regulations.

Has measures to ensure third-party compliance with ethical marketing and anti-corruption standards. AstraZeneca has a code of conduct and policy relating to ethical marketing and anti-corruption, and provides compliance training for employees on an annual basis. The company provides evidence of having formal processes in place to ensure compliance with standards by third parties. Sales agents' rewards are not solely based on sales targets. Instead, it rewards other qualities, such as accountability and integrity in the workplace. 

Internal control framework meets some Index criteria. AstraZeneca's internal control framework to ensure compliance meets some of the criteria looked for by the Index. Namely, it has an auditing and review mechanism in place, and it reports that it regularly conducts fraud-specific risk assessments. It also has a monitoring system for compliance. However, it did not demonstrate evidence of procedures to segregate duties, so that decisions are checked by another party. 

Above average transparency regarding access-related practices. AstraZeneca publicly discloses its policy positions on access-related topics (e.g., its positions on intellectual property). It discloses political contributions in countries in scope. AstraZeneca publicly discloses its membership of relevant institutions to access, but does not disclose whether it provides financial support. The company also discloses its policies for responsible engagement through its Global Policy on Ethical Interactions. During the period of analysis, AstraZeneca did not publicly disclose its policy approach to payments made to healthcare professionals in countries in scope. Following the period of analysis, the company shared plans to disclose such payments, including countries in North Africa and Latin America.

Commits to R&D to meet public health needs. AstraZeneca has made a specific commitment to R&D for diseases and countries in scope, but it is not publicly available. Its R&D strategy for low- and middle-income countries is informed by an evidence-based public health rationale through its "5R framework" (to help ensure the right target, patient, tissue, safety and commercial potential). Further, it has time-bound strategies for completing R&D projects for diseases in scope and evaluates progress toward these targets. AstraZeneca has the largest pipeline in the Index with 218 projects. For diseases in scope where priorities exist, AstraZeneca is active in eight projects; six of these target priority R&D gaps.

No access provisions; process in place for setting them. AstraZeneca has a general process in place to develop access plans during R&D. It is unclear whether this applies to all or some of the company's R&D projects. Mainly, AstraZeneca develops access plans for R&D projects in Phase III of clinical development. To date, AstraZeneca does not have any project-specific access provisions in place for its late-stage R&D projects. 

Policy to ensure post-trial access; commits to registering trialed products. AstraZeneca has a policy for ensuring post-trial access to treatments for clinical trial participants and has provided a detailed example of this policy in action in countries in scope. However, this policy is not publicly available. The policy is aligned with the standards set in the Declaration of Helsinki. Once a product is approved, AstraZeneca commits to registering it in all countries where clinical trials for the product have taken place. 

*Defined as a recommended time frame through consultation with stakeholders during Index methodology development.