Key findings
Companies step up access planning for pipeline products, but progress lags for non-communicable diseases
10 November 2026
10 November 2026
2026 Access to Medicine Index
The tenth iteration of the 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 such as medicines, vaccines and diagnostics accessible to people in low- and middle-income countries.
Every two years, the Index assesses how companies are addressing key access-to-medicine issues. Drawing on comprehensive analysis, the report showcases Best Practices, highlights areas of progress and identifies where urgent action is needed. It also outlines opportunities and practical solutions to advance long-term, scalable and sustainable access to essential healthcare products.Â
The 2026 Index evaluated, scored and ranked 20 of the world’s leading innovative pharmaceutical companies based on 29 metrics spanning three Technical Areas: Governance of Access, Research & Development (R&D) and Product Delivery. Companies’ products and R&D projects for 84 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). 
What’s in the 2026 report?
2026 Ranking
In the 2026 Index, Novartis takes the top spot in the ranking followed closely by GSK, both overall and in each of the three Technical Areas. Close behind these two leaders are six companies that perform above average across the Technical Areas: including AstraZeneca (3rd), Sanofi (4th), Bayer (5th), Boehringer Ingelheim (6th), Roche (6th) and Pfizer (8th).Â
3 Key findings
Companies step up access planning for pipeline products, but progress lags for non-communicable diseases Â
Promising pockets of progress emerge in cancer access, but the overall picture remains unevenÂ
Inclusive business models: Momentum in expanding reach and strengthening long-term foundations, yet visibility into impact remains limited  Â
20 report cards
Each company has a report card providing a detailed overview of its performance in the 2026 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.Â
5 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. For the 2026 Index, there is one in Governance of Access, two in Research & Development and two in Product Delivery.
20 years of the Index
The 2026 Index marks ten editions of tracking and catalysing progress in access to medicine. To mark this milestone, the report includes a unique lookback analysis examining two decades of change in how pharmaceutical companies approach access to medicine and how the industry has evolved over time.Â
Technical area trends
The 2026 Access to Medicine Index highlights an industry at a crossroads. Access to medicine is becoming more deeply embedded in company operations, from long-term strategies and executive-level engagement to access planning during product development. But alongside these developments, persistent barriers remain.Â
Governance of access
Governance of Access remains the strongest-performing Technical Area, with room for improvement in measuring and reporting patient reach.Â
Research & Development
The 2026 Index shows a continued shift away from priority R&D with the number of companies involved in R&D for priority diseases falling to its lowest level since 2018.
Product Delivery
Companies continue to perform strongly in capacity building and mostly investing in local manufacturing and supply chain capabilities. In other areas, performance varies.Â
