The latest ‘Access to Medicine Index’, a biennial study that ranks the top 20 innovator companies on 7 parameters related to access, has been released for 2016 (for our coverage of the 2008 and 2014 Indices, see here and here). The Index assesses how effectively the top 20 research-based pharmaceutical companies make medicines, vaccines and diagnostics more accessible in the middle and low income countries. It is brought out by ‘The Access to Medicine Foundation’ funded by the UK Department of International Development (UK aid), the Bill & Melinda Gates Foundation and the Dutch Ministry of Foreign Affairs. For the fifth consecutive time, the top spot went to GlaxoSmithKline (‘GSK’) ahead of companies such as Johnson & Johnson, Novartis, Merck KGaA and Merck & Co. Inc, who filled up the rest of the top 5 positions. Overall, a moderate progress has been observed by the Index vis a vis the industry’s efforts at improving access during its current cycle of study.
Key findings
The Index itself identifies four key findings. The first one is in relation to research and development of products (medicines, vaccines and devices) for the most burdensome diseases, which have low commercial potential but are urgently required, mostly by the poor. As per the Index, around 151 products of the above description are being presently developed. Nevertheless, we are all too aware of the possibility of the development being focused around a few diseases, which could potentially reap rewards in the non-low income countries. But, this is certainly not the case as the Index points out that of the 22 most burdensome diseases identified, as high as 18 are being addressed by companies. Certain neglected tropical diseases like Buruli ulcer and soil-transmitted helminthiasis continued to have zero or very few R&D projects aimed at them while the most amount of focus was on HIV/ AIDS, tuberculosis and viral hepatitis. There are some interesting insights into the funding of these R&D efforts with three fourths of the 151 high-priority products being developed by a group of six companies and GSK again leading the pack. Another key takeaway from the report is that 67% of the R&D projects are being carried out in partnership and within that, public, non-governmental and/or non-profit organisations are the partners in three quarters of the cases.
Another key area identified by the Index is the registration of products once they come out of the pipeline and the effective deployment of these products thereafter in the market (since deployment of pharmaceutical products requires registration). The findings on this count do not make for great reading with companies registering their products only in a quarter of the surveyed countries, thus limiting effective deployment. Nevertheless, deployment by way of voluntary licences in the case of HIV/ AIDS has increased and hepatitis c has been covered for the first time by voluntary licences.
Another significant finding is that most companies ranked by the Index now have an access–to-medicine strategy. It is noteworthy that a majority of the companies have designed their strategy on access in order to improve their business by way of gaining entry into hitherto unexplored markets, expanding consumer base and long term financial gains.
Companies under assessment have also made some significant strides when it comes to capacity building in low and middle income countries. By laying emphasis on building health systems in these countries with an eye on each link of the value chain, companies have been able to address some of the gaps in health infrastructure of these countries. Six companies-AstraZeneca, GSK, Johnson & Johnson, Merck & Co., Inc., Merck KGaA and Novartis- have come in for special mention for their consistent efforts at addressing these gaps through their capacity building programmes.
Apart from the key findings discussed above, the Index also provides an in-depth analysis of how each company has fared, in the form of report cards. For those interested, the full report may be accessed here.
(Image from here)