Company report cards & comparison

Insights

GSK tops the ranking

GSK retains the number one spot, followed closely by Johnson & Johnson. AstraZeneca has newly joined the top three. Merck joins the top five, and Bayer rises into the top ten.

Report Cards highlight next steps

The Index includes a set of 20 Report Cards that provide detailed overviews of each company’s performance, and outline specific opportunities for improvement tailored to each company.

Some progress, some stagnation

There are signs of progress across the industry, with more pharmaceutical companies taking an increasingly systematic approach to access to medicine. However, progress is not uniform in all areas. For example, there have been limited changes in R&D pipeline.

Subrankings

Governance of Access

The top spot is held by Pfizer. The company provides evidence of well-established structures of governance and management, with responsibility assigned and access-to-medicine incentives offered at the highest level, It takes a strong approach to ensuring ethical business practices, and also has stringent compliance processes across its operations. Joint for second place are AstraZeneca, GSK, Johnson & Johnson, Novo Nordisk, Sanofi and Takeda.

Research & Development

The top spot is retained by GSK, followed closely by Johnson & Johnson and Novartis. Out of all 20 companies, GSK has the largest number of projects in development that target priority diseases such as malaria and HIV/AIDS. Johnson & Johnson and Novartis also engage in R&D for priority diseases, with both companies having access plans for LMICs covering all late-stage R&D projects in the pipeline.

Product Delivery

AstraZeneca takes the top spot in Product Delivery, leading in its approach to patent transparency and sharing of intellectual property assets. It has made progress by licensing and transferring technology for its COVID-19 vaccine. GSK and Johnson & Johnson complete the top three, performing well across all assessment criteria, including equitable access strategies. Novartis comes 4th; notably, in 2022 it became the first company to agree to a non-exclusive voluntary licence for a medicine to treat a non-communicable disease.

Ranking Analysis

Four companies stand out as leaders

In the 2022 Index, GSK retains the number one spot, followed closely by Johnson & Johnson. AstraZeneca has risen to third, with Novartis in fourth. These four companies are the clear leaders among the companies assessed by the Index...

High-performing companies

The companies ranked 5th to 10th are high performers on access to medicine, competing closely in the overall ranking. Merck (5th) excels in R&D access planning, with access plans in place for all late-stage R&D projects and performs strongly its approach to patent transparency. Pfizer (6th) leads in Governance of Access for its approach to incentivising responsible promotional practices. Takeda (7th) is a top performing company in R&D access planning and equitable access strategies for products that are administered by healthcare practitioners...

Middle-performing companies

Novo Nordisk (11th) has strong policies governing access and builds capacity by engaging in health systems strengthening. Eisai (12th) has an average performance overall across the three Technical Areas, with a particularly strong performance in long-term product donations. Boehringer Ingelheim (13th) has an average performance in the Technical Areas, but has introduced a comprehensive new framework for R&D access planning, and performs well in expanding access via inclusive business models...

Low-performing companies

The bottom of the ranking is rounded out by five companies whose performance is below average for much for criteria assessed by the Index. Astellas (16th) has strengthened its access planning processes during R&D and has comparatively strong policies in place for Governance of Access, but falls behind its peers in applying equitable access strategies to its products in LMICs. Daiichi Sankyo (17th) performs relatively well in intellectual property (IP) sharing, but lags in all Technical Areas...

How companies were assessed in the 2022 Index

The 2022 Access to Medicine Index assesses 20 of the world’s largest pharmaceutical companies in relation to their efforts to expand access to medicine for people living in 108 low- and middle-income countries. It looks at 83 diseases, conditions and pathogens, which have been identified as the most critical priorities. Companies are scored and ranked based on 31 indicators which are spread across three Technical Areas: Governance of Access, Research & Development, and Product Delivery.

Learn more about what the Index measures

The Methodology for the 2022 Access to Medicine Index

Read more

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.

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.

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.

Trends

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

Good practice is becoming more common in the actions taken by pharmaceutical companies to limit the threat of antimicrobial resistance (AMR). This 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.

Large R&D-based companies

Pfizer makes significant strides to become joint leader alongside GSK

GSK and Pfizer are joint leaders of the large research-based companies in 2021. They are followed by Johnson & Johnson. Although all three leaders perform well across the board, Pfizer made significant improvements in the scale and scope of its efforts to address AMR, and signalled a clear boost to its infectious diseases R&D.

Generic medicine manufacturers

Three new leaders in 2021, as stewardship and access measures increase

Aurobindo, Abbott and Viatris take the lead among the generic medicine manufacturers in 2021. Each of these companies is filing its medicines for registration in low- and middle- income countries, and has improved its sales practices to mitigate the risk of overselling. Abbott, Cipla and Viatris are the first generic medicine manufacturers to report environmental risk-management strategies that apply to their suppliers’ sites, as well as their own sites. They also report that they check whether suppliers’ sites comply with limits set for environmental standards. Transparency by generic medicine manufacturers has once again increased, amidst the COVID-19 pandemic.

The Methodology

The goal of the Antimicrobial Resistance Benchmark is to guide and incentivise pharmaceutical companies to do more to tackle drug-resistance. It identifies good ideas for limiting AMR and highlights where action is still required. To fairly compare the diverse companies, the Benchmark evaluated them only in those metrics that are relevant to their portfolio and pipelines, comparing them in three groups: large research-based pharmaceutical companies, generic medicine manufacturers and pharmaceutical SMEs (small- and medium-sized enterprises).