Key findings
Pharma companies are taking steps to address access in low-income countries, but significant gaps remain
19 November 2024
2024 Access to Medicine Index
The 9th Access to Medicine Index offers an in-depth analysis of how 20 of the world’s leading pharmaceutical companies are performing in making essential healthcare products – from vaccines to diagnostics – accessible to people in low- and middle-income countries (LMICs).
Every two years, the Index evaluates companies on their performance on key access-to-medicine issues. Drawing on comprehensive analysis, the report not only highlights Best Practices and areas where progress has been made, but identifies where urgent action is needed, along with solutions for long-term, scalable and sustainable access to essential healthcare products.Â
The 2024 Index assessed, scored and ranked 20 of the world’s leading innovative pharmaceutical companies based on 32 metrics spanning three Technical Areas: Governance of Access, Research & Development (R&D) and Product Delivery. Companies’ products and R&D projects for 81 diseases, conditions and pathogens that have been identified as the most critical priorities regarding access to medicine are included in the analysis, which covers 113 low- and middle-income countries (LMICs).Â
What’s in the 2024 report?
2024 RANKING
Novartis has risen to claim the top spot, putting GSK – the long-time leader – into second place. Both companies rank within the top three performers across all three Technical Areas analysed in the 2024 Index. The two leaders are followed by four high-performing companies that rank above average in all Technical Areas, leaving little separation between them in terms of overall performance: Sanofi (3rd), Pfizer (4th), with AstraZeneca and Johnson & Johnson (tied in 5th).  
3 KEY FINDINGS
Pharma companies are taking steps to address access in low-income countries, but significant gaps remain
Patients in low- and middle-income countries largely left out of clinical trials, limiting access to new treatments
Efforts to ramp up wider local availability of medicines through voluntary licensing and technology transfers are limited
20 REPORT CARDS
Each company has a report card providing a detailed overview of its performance in the 2024 Index, including a summary of its strengths and weaknesses, drivers behind changes in its ranking, as well as tailored opportunities to improve and maximise its access-to-medicine efforts.
8 BEST PRACTICES
Best Practices are ones that can be accepted as being the most effective way of achieving a desired end, relative to what the industry is currently doing in that area and what stakeholder expectations are. Some of these focus on a single company, while others draw on examples from several companies.
Industry trends
The Index finds that although some modest progress has been made, the potential for improving access is still far from realised, and the pace of change is slow. Coverage remains patchy and many populations – especially those in the poorest countries – are still largely overlooked.
Governance of Access
Overall strong performance in Governance of Access, but room for improvement in measuring and reporting patient reach.
Product Delivery
Varied performance in Product Delivery, with strong efforts in health system strengthening and quality and supply, but stagnation in voluntary licensing.
Research & Development
Lowest performance in R&D, with biggest gap seen in product development, and considerable gaps in quality and geographic scope of companies’ R&D access plans.
