Antimicrobial Resistance Benchmark

Tracking progress on Opportunities 

To stimulate progress, the Access to Medicine Foundation sets “Opportunities” for individual companies to pursue – a groundbreaking, practical and proven approach to moving companies in the right direction on critical access-to-medicine priorities. The 2021 AMR Benchmark pinpointed 3-5 tailored Opportunities for each of the 17 pharmaceutical companies in scope, identifying specific ways for companies to do more to curb AMR and improve access to antimicrobial products in low- and middle-income countries (LMICs).  

In November 2023, using data submitted by companies and information from the public domain, the Foundation published a report that provides a vital update on the progress achieved by these 17 companies in with regards to each of their Opportunities.  

Findings in 2023 

The industry analysis in the November 2023 report reveals collective trends, both in terms of action and inaction, shedding light on the factors that have influenced the extent of progress achieved thus far – and where more action is required from companies. For Opportunities related to access, some progress can be seen among companies – especially in expanding product registration and engaging in long-term initiatives to boost availability and affordability. However, despite a handful of acquisitions to expand R&D pipelines, R&D projects targeting priority pathogens and urgent AMR threats are still lacking, and there has been no progress on Opportunities to delink bonuses from sales volume. 

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Antimicrobial Resistance Benchmark 2021

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2021 Benchmark – Trends 

Good practice is becoming more common. Action to address access lags behind. 

Good practice is most notable in the plans to ensure wider access to and responsible use of future products, as well as in the steps taken to curb the release of antibiotic waste into the environment. In stewardship, generic medicine manufacturers are taking a more active role. However, all companies miss opportunities to improve access in low- and middle-income countries (LMICs), where the need is greatest and where people face the greatest threat from superbug infections. 

2021 Benchmark – scoring companies 

The goal of the Antimicrobial Resistance Benchmark is to guide and incentivise pharmaceutical companies to do more to tackle drug resistance and ensure appropriate access to antibiotics, antifungals and other antimicrobial products. It identifies good ideas for limiting AMR and highlights where action is still required.  

The methodology for the 2021 Benchmark was developed after consultation with an Expert Committee, as well as many other global health stakeholders, and was published in October 2020. The 2021 Benchmark evaluated 17 companies, including 8 large research-based companies and 9 generic medicine manufacturers, looking at their performance across a set of 20 metrics. To fairly score and compare the companies, the Benchmark evaluated them only in those metrics that were relevant to their portfolio and pipelines. 

2021: Insights - Research & Development

GSK maintains lead in antibacterial and antifungal R&D to target priority pathogens

GSK's pipeline is the largest evaluated, with 31 projects in the pipeline. It addresses more pathogens designated as ‘critical’ and/or ‘urgent’ threats, and has most vaccines projects underway.

R&D pipeline grows, but remains small overall

Since the previous analysis, 22 projects have left the pipeline, but there have been 38 additions. As a result, the pipeline has modestly increased in size, by 15 projects, from 77 to 92.

Sustained R&D for AMR from most companies

Only one of the eight companies evaluated is not currently active in R&D targeting priority pathogens. The remaining seven have sustained their involvement, and several have expanded their pipelines. Pfizer and GSK stand out for adding five and four projects, respectively. 

Which pathogens are receiving most attention in R&D

The World Health Organization and US Centers for Disease Control have identified the most dangerous pathogens due to resistance. The eight large research-based companies evaluated are developing 92 medicine and vaccine projects that target them.

2021: Insights - Responsible manufacturing

Progress on limiting antibiotic waste in environment

More companies are setting and enforcing limits for antibacterial material that can be released in manufacturing wastewaters. Companies generally perform best at implementing these limits at their own factories. However, just 5.2% of third-party manufacturing sites are reported as compliant.

More companies require suppliers to set AMR limits

Companies generally perform best at setting and monitoring specific AMR-related environmental standards at their own manufacturing sites. For the first time, the Benchmark reports that three generic medicine companies now require suppliers also meet such standards.

Shionogi is first to publish the details of its antibacterial waste-management performance

Shionogi has published information on audit results covering wastewater management, solid-waste management and discharge limits. Its disclosure covers all antibacterial APIs and/or drug products produced at its site in Japan and at supplier sites.

How pharma companies manage antibacterial waste

Many factories around the world are involved in the production of antibacterials, with many based in India and China. If these manufacturing sites do not manage their waste appropriately, the discharge of wastewaters containing active pharmaceutical ingredients (APIs) into the environment can trigger resistance.

2021: Insights - Appropriate access & stewardship

Improvement in antimicrobial sales practices, especially from generics companies

When sales agents’ bonuses are linked to how much antibacterial and antifungal medicine is sold, this acts as an incentive for these staff to oversell in order to increase their own pay. In 2021, more generic medicine manufacturers are taking action to combat overselling.

Tech transfers are being carried out as isolated, yet valuable, initiatives

To support the development of local manufacturing in low and middle income countries, pharma companies can invest in capacity building and technology transfers. Half of the on-patent vaccines analysed are subject to a technology transfer initiative. Very few initiatives cover any of the 148 medicines analysed.

Most companies support efforts to track resistance

To control the spread of resistance, it is important to track cases and infection rates. Most companies are engaged in surveillance to some extent: all of the eight large research-based companies evaluated, except Otsuka, and three generic medicine manufacturers, Abbott, Cipla and Viatris.

Slow progress on expanding product registrations to low- and middle-income countries

Less wealthy nations often have the highest need for new medicines arriving on the market. Yet only six of the sampled on-patent medicines have been filed in ten or more of the 102 low- and middle-income countries prioritised for this analysis.