Access to Medicine Index

Last updated

The Access to Medicine Index is a ranking system published biennially since 2008 by the Access to Medicine Foundation, an international not-for-profit organisation based in Amsterdam, the Netherlands. It ranks 20 of the world's largest pharmaceutical companies according to their ability to make their pharmaceutical drugs more available, affordable and accessible in low- and middle-income countries. [1] The Index aims to stimulate companies to improve access in developing countries, to show the activities of their peers, [2] [3] and allow them, governments, investors, civil society, patient organisations and academia to understand how pharmaceutical companies can make further progress. The 2022 Access to Medicine Index was funded by the Dutch Ministry of Foreign Affairs, the UK Foreign, Commonwealth and Development Office, the Bill & Melinda Gates Foundation, Axa Investment Managers, and the Wellcome Trust. [4] [5]

Contents

Ranking

The latest Access to Medicine Index, published in November 2022, ranked the 20 pharmaceutical companies as follows: [6] [5]

Company name (2022 score)2022 ranking2021 ranking2018 ranking2016 ranking
GSK plc (4.06)1111
Johnson & Johnson (4.03)2323
AstraZeneca plc. (3.93)3732
Novartis AG (3.87)421114
Merck KGaA (3.72)5876
Pfizer Inc (3.62)64515
Takeda Pharmaceutical Co. Ltd (3.51)7697
Sanofi (3.47)8544
Bayer AG (3.36)9131019
Roche Holding AG (3.23)109610
Novo Nordisk A/S (2.97)1110811
Eisai Co. Ltd (2.95)12111416
Boehringer Ingelheim (2.93)13121612
Gilead Sciences (2.84)14141920
Bristol Myers Squibb (2.60)1519138
Astellas Pharma Inc (2.46)1614125
Daiichi Sankyo Co. Ltd (2.20)17161818
Merck & Co. Inc (2.15)1815179
AbbVie Inc (1.84)19172017
Eli Lilly & Co (1.79)20181513

History

The Access to Medicine Index was developed starting in 2004 on the initiative of Dutch entrepreneur Wim Leereveld. [7] After years of working with the pharmaceutical industry, he concluded that simply "naming and shaming" the industry did not do enough to encourage pharmaceutical companies to play their part in improving access to medicine in the developing world. Leereveld noticed that there were many different (and sometimes conflicting) opinions about what the pharmaceutical industry should be doing with regard to access to medicine, but that there was no tool to recognise good practice within the pharmaceutical industry and no framework for collective dialogue surrounding this issue. He set out to develop a ranking system that would show which pharmaceutical companies do the most to improve access to medicine and how, and also help stakeholders to collectively define companies' role in increasing access to medicine. [7]

The first Access to Medicine Index was published in 2008, followed by new Indexes in 2010, 2012, 2014, 2016, 2018, 2021 and 2022.

Methodology

The methodology for the Access to Medicine Index is reviewed every two years, ahead of each analysis. The methodology for the 2024 Index, due for publication in November 2024, was published in October 2023. [8]

The Access to Medicine Index uses a weighted analysis to capture and compare data which the companies provide, as well as publicly available data. The framework is constructed along three areas of focus called "Technical Areas", which cover the range of company business activities considered relevant to access to medicine: Governance of Access, Research and Development, and Product Delivery. [8]

The methodology for the 2024 Index includes a greater focus on 'patient reach'. Jayasree K. Iyer, CEO of the Foundation, said this was settled on “after engaging with various stakeholders, from the World Health Organisation to patient organisations, NGOs, governments, and investors to arrive at a multi-stakeholder consensus.” [9]

Scope

Company scope

The Access to Medicine Index ranks 20 of the world's largest originator (research-based) pharmaceutical companies, based on market capitalisation and the relevance of their product portfolios to diseases in the developing world. One unlisted company, Boehringer Ingelheim, is also included since it meets the size and portfolio relevance criteria.

In 2008 and 2010, the first two editions of the Access to Medicine Index, companies engaged exclusively in the production of generic drugs were also assessed. [10] [11] Based on feedback from the 2011 stakeholder consultations, these companies were excluded from the 2012 Index and subsequent iterations. The Access to Medicine Foundation stated that it recognised that these companies play a significant role in access to medicine, particularly in low- and middle-income countries. [1] [12] [13] [14] [15] In 2023, the Access to Medicine Foundation launched a dedicated Generic & Biosimilar Medicines Programme, with its own analytical framework. [16] [17]

Geographic scope

The Access to Medicine Index focuses on low- and middle-income countries, based on World Bank and United Nations classifications measuring economic advancement, human development, and relative levels of inequality. [18] [19] The 2022 Index measured developments in a total of 108 countries, including countries considered to be low income and lower-middle income countries by the World Bank, and Least Developed Countries as defined by the United Nations Economic and Social Council. [20] In addition, countries classified as low human development countries and medium human development countries by the UN Human Development Index are included. Finally, based on the UN Inequality-Adjusted Human Development Index, the index includes countries which, while they may have higher measures of development, have comparatively high levels of socio-economic inequality. [1]

Disease scope

The Access to Medicine Index covers a range of diseases based on their aggregate global disease burden and their relevance to pharmaceutical interventions, in accordance with non-age-weighted WHO Disability Adjusted Life Years (DALY) [21] data. In the 2022 Index, the disease scope included 83 diseases, conditions and pathogens identified as the most critical priorities regarding access to medicine. [22]

Product type scope

To reflect the range of available product types for prevention, diagnosis and treatment of diseases, the Index maintains a broad product type scope which draws closely from definitions provided by the G-Finder Report. [23]

Reception

The Access to Medicine Index has become a frequently cited benchmark for pharmaceutical companies with regard to their access to medicine initiatives. In addition to global media outlets reporting on the Access to Medicine Index and its findings, significant coverage includes:

Criticism

The results of the Access to Medicine Index are largely based on company data provided by the pharmaceutical companies themselves. Self-reported data does carry with it an inherent risk, but the Access to Medicine Index also uses dependable external sources to verify data provided by the companies wherever possible. Additionally, it is in companies' best interest to be as forthcoming as possible, as they are a) rated by the index on their degree of transparency and b) rated on their performance every two years, so that failures to meet their commitments and/or inconsistencies over time are likely to be uncovered. Besides, as drug access is only one dimension of the Corporate Social Responsibility (CSR) within the pharmaceutical industry, it would not be reasonable to evaluate the CSR practices of pharmaceutical companies only using this index.

Related Research Articles

A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations.

<span class="mw-page-title-main">Pfizer</span> American multinational pharmaceutical and biotechnology corporation

Pfizer Inc. is an American multinational pharmaceutical and biotechnology corporation headquartered at The Spiral in Manhattan, New York City. The company was established in 1849 in New York by two German entrepreneurs, Charles Pfizer (1824–1906) and his cousin Charles F. Erhart (1821–1891).

<span class="mw-page-title-main">Medication</span> Substance used to diagnose, cure, treat, or prevent disease

A medication is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management.

<span class="mw-page-title-main">GSK plc</span> British multinational pharmaceutical and biotechnology company

GSK plc is a British multinational pharmaceutical and biotechnology company with global headquarters in London. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham, GSK is the tenth largest pharmaceutical company and #294 on the 2022 Fortune Global 500, ranked behind other pharmaceutical companies China Resources, Sinopharm, Johnson & Johnson, Pfizer, Roche, AbbVie, Novartis, Bayer, and Merck Sharp & Dohme.

An orphan drug is a pharmaceutical agent that is developed to treat certain rare medical conditions. An orphan drug would not be profitable to produce without government assistance, due to the small population of patients affected by the conditions. The conditions that orphan drugs are used to treat are referred to as orphan diseases. The assignment of orphan status to a disease and to drugs developed to treat it is a matter of public policy that depends on the legislation of the country.

<span class="mw-page-title-main">Pharmaceutical industry</span> Industry involved with discovery, development, production and marketing of drugs

The pharmaceutical industry is an industry in medicine that discovers, develops, produces, and markets pharmaceutical drugs for use as medications to be administered to patients, with the aim to cure and prevent diseases, or alleviate symptoms. Pharmaceutical companies may deal in generic or brand medications and medical devices. They are subject to a variety of laws and regulations that govern the patenting, testing, safety, efficacy using drug testing and marketing of drugs. The global pharmaceuticals market produced treatments worth $1,228.45 billion in 2020 and showed a compound annual growth rate (CAGR) of 1.8%.

The 10/90 gap is the term adopted by the Global Forum for Health Research to highlight the finding by the Commission on Health Research for Development in 1990, that less than 10% of worldwide resources devoted to health research were put towards health in Developing Countries, where over 90% of all preventable deaths worldwide occurred. Every year, the spread of disease suffered in both rich and poor countries converges. According to the World Health Organization (WHO), the most prevalent diseases consist of cardiovascular disease, cancer and diabetes. These diseases now account for 45% of the global health burden and are the culprit for up to 85% of deaths in low-income countries. The 10/90 Gap focuses on joining organizations together to reduce these statistics.

<span class="mw-page-title-main">Vertex Pharmaceuticals</span> American pharmaceutical company

Vertex Pharmaceuticals is an American biopharmaceutical company based in Boston, Massachusetts. It was one of the first biotech firms to use an explicit strategy of rational drug design rather than combinatorial chemistry. It maintains headquarters in South Boston, Massachusetts, and three research facilities, in San Diego, California, and Milton Park, Oxfordshire, England.

<span class="mw-page-title-main">Global health</span> Health of populations in a global context

Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems that transcend national borders or have a global political and economic impact are often emphasized. Thus, global health is about worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders, including the most common causes of human death and years of life lost from a global perspective.

<span class="mw-page-title-main">Drugs for Neglected Diseases Initiative</span> Non-profit organization

The Drugs for Neglected Diseases initiative (DNDi) is a collaborative, patients' needs-driven, non-profit drug research and development (R&D) organization that is developing new treatments for neglected diseases, notably leishmaniasis, sleeping sickness, Chagas disease, malaria, filarial diseases, mycetoma, paediatric HIV, cryptococcal meningitis, hepatitis C, and dengue. DNDi's malaria activities were transferred to Medicines for Malaria Venture (MMV) in 2015.

<span class="mw-page-title-main">Neglected tropical diseases</span> Diverse group of tropical infectious diseases which are common in developing countries

Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bacteria, protozoa, and parasitic worms (helminths). These diseases are contrasted with the "big three" infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of neglected tropical diseases as a group is comparable to that of malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.

<span class="mw-page-title-main">Unitaid</span> Global health initiative

Unitaid is a global health initiative that works with partners to bring about innovations to prevent, diagnose and treat major diseases in low- and middle-income countries, with an emphasis on tuberculosis, malaria, and HIV/AIDS and its deadly co-infections. Founded in 2006, the organization funds the final stages of research and development of new drugs, diagnostics and disease-prevention tools, helps produce data supporting guidelines for their use, and works to allow more affordable generic medicines to enter the marketplace in low- and middle-income countries. Hosted by the World Health Organization (WHO) in Geneva, Unitaid was established by the governments of Brazil, Chile, France, Norway and the United Kingdom.

mHealth Medicine and public health supported by mobile devices

mHealth is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and personal digital assistants (PDAs), and wearable devices such as smart watches, for health services, information, and data collection. The mHealth field has emerged as a sub-segment of eHealth, the use of information and communication technology (ICT), such as computers, mobile phones, communications satellite, patient monitors, etc., for health services and information. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery/sharing of healthcare information for practitioners, researchers and patients, real-time monitoring of patient vital signs, the direct provision of care as well as training and collaboration of health workers.

Medication costs, also known as drug costs are a common health care cost for many people and health care systems. Prescription costs are the costs to the end consumer. Medication costs are influenced by multiple factors such as patents, stakeholder influence, and marketing expenses. A number of countries including Canada, parts of Europe, and Brazil use external reference pricing as a means to compare drug prices and to determine a base price for a particular medication. Other countries use pharmacoeconomics, which looks at the cost/benefit of a product in terms of quality of life, alternative treatments, and cost reduction or avoidance in other parts of the health care system. Structures like the UK's National Institute for Health and Clinical Excellence and to a lesser extent Canada's Common Drug Review evaluate products in this way.

<span class="mw-page-title-main">Klaus M. Leisinger</span> Swiss social scientist and economist (born 1947)

Klaus M. Leisinger is a social scientist and economist. He is founder and president of the Global Values Alliance in Basel. Until 2012 he was managing director and chairman of the Board of Trustees of the Novartis Foundation in Basel, Switzerland.

Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance.

Access to medicines refers to the reasonable ability for people to get needed medicines required to achieve health. Such access is deemed to be part of the right to health as supported by international law since 1946.

Health Action International (HAI) is a non-profit organization based in The Netherlands. Established in 1981, HAI works to expand access to essential medicines through research, policy analysis and intervention projects. The organization focuses on snakebite envenoming, access to insulin and developing European policies on medicines. HAI is listed by the World Health Organization (WHO) as an official non-state actor.

External reference pricing (ERP), also known as international reference pricing, is the practice of regulating the price of a medication in one country, by comparing with the price in a "basket" of other reference countries. It contrasts with internal reference pricing, where the price of one drug is compared to the domestic price of therapeutically related drugs, and with cost-plus pricing, where the price involves negotiating an acceptable markup to the unit cost to develop and produce.

<span class="mw-page-title-main">Initiative for Medicines, Access, and Knowledge</span> Nonprofit organization

The Initiative for Medicines, Access, and Knowledge, known as I-MAK, is a U.S.-based global 501(c)(3) organization that advocates in the public interest for affordable access to medicines, and a medicines system that is more inclusive of patients and the public.

References

  1. 1 2 3 Access to Medicine Foundation. "The 2017 Access to Medicine Index: Methodology 2018" (PDF). Access to Medicine Foundation. Archived from the original (PDF) on 27 November 2018. Retrieved 27 November 2018.
  2. Access to Medicine Foundation. "What is the Index?". Archived from the original on 31 October 2015. Retrieved 29 October 2015.
  3. World Health Organization. "Medicines in Health Systems" (PDF). WHO. Retrieved 27 October 2015.
  4. UK Department for International Development. "The Access to Medicine Index: Encouraging global access to health care". DFID News. DFID. Retrieved 11 March 2013.
  5. 1 2 The Access To Medicine Foundation (December 21, 2021). "The Access to Medicine Index 2021". Archived from the original on 2021-01-27. Retrieved 21 December 2021.
  6. Access to Medicine Foundation. "2018 Access to Medicine Index" (PDF). Archived from the original (PDF) on 27 November 2018. Retrieved 27 November 2018.
  7. 1 2 Levy, Gideon. "Patents or Patients". AVRO. Retrieved 11 March 2013.
  8. 1 2 "New 2024 Index Methodology places greater focus on measuring patient reach". Access to Medicine Foundation. Retrieved 2023-11-09.
  9. "Access to Medicine Index 2024 to Prioritise 'Patient Reach'". PharmaBoardroom. Retrieved 2023-11-09.
  10. "2008 Access to Medicine Index". Access to Medicine Foundation. Retrieved 2023-11-09.
  11. "2010 Access to Medicine Index". Access to Medicine Foundation. Retrieved 2023-11-09.
  12. Access to Medicine Foundation. "Methodology Report 2013 for the 2014 Access to Medicine Index" (PDF). Archived from the original (PDF) on 26 February 2015. Retrieved 29 October 2015.
  13. Access to Medicine Foundation. "2012 Methodology Report - Stakeholder Review" (PDF). Archived from the original (PDF) on 14 July 2015. Retrieved 29 October 2015.
  14. Access to Medicine Foundation. "2010 Methodology Report - Stakeholder Review" (PDF). Archived from the original (PDF) on 1 March 2015. Retrieved 29 October 2015.
  15. Access to Medicine Foundation. "2008 Methodology Report - Stakeholder Review" (PDF). Archived from the original (PDF) on 1 March 2015. Retrieved 29 October 2015.
  16. Datta, PT Jyothi (2023-02-15). "Framework to assess, nudge generic drug makers to expand access to products". BusinessLine. Retrieved 2023-11-09.
  17. Iyer, Jayasree (2023-02-15). "Poor countries desperately need better access to generic medicines". Financial Times. Retrieved 2023-11-09.
  18. "Least Developed Countries: UN Classification". The World Bank. Retrieved 11 March 2013.
  19. "How we classify countries". World Bank. Retrieved 11 March 2013.
  20. UN Capital Development Fund. "Least Developed Countries" . Retrieved 27 October 2015.
  21. "Health statistics and health information systems: DALY". World Health Organization. Retrieved 11 March 2013.
  22. "2022 Access to Medicine Index | Access to Medicine Foundation". accesstomedicinefoundation.org. Retrieved 2023-11-09.
  23. "G-Finder 2017 - Neglected Disease Research and Development: Reflecting on a Decade of Global Investment". Policy Cures. Retrieved 27 November 2018.
  24. Gates, Bill & Kiviat, Barbara (31 July 2008). "Making Capitalism More Creative". Time . Archived from the original on July 18, 2011. Retrieved 11 March 2013.
  25. Hunt & Khosla, Paul, Rajat (28 September 2010). "Are Drug Companies Living Up to Their Human Rights Responsibilities? The Perspective of the Former United Nations Special Rapporteur (2002-2008)". PLOS Medicine. 7 (9): e1000330. doi: 10.1371/journal.pmed.1000330 . PMC   2946950 . PMID   20927413.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. "Global Pharma: Doing well by doing good?" (PDF). UBS Investment Research. Retrieved 18 June 2013.[ permanent dead link ]
  27. "【国際】医薬品アクセスインデックス2021、首位GSK。上位企業がさらに躍進。下位との差開く". Sustainable Japan | 世界のサステナビリティ・ESG投資・SDGs (in Japanese). 2021-01-30. Retrieved 2023-12-07.
  28. Nomura Asset Management U.K. Limited, Nomura Global Sustainability Equity Fund Impact Report 2020
  29. "Equitable access to medicine contributes to sustainable growth". sebgroup.com. Retrieved 2023-12-07.
  30. "Member Musing - Australian Ethical". Responsible Investment Association Australasia (RIAA). Retrieved 2023-12-07.
  31. Yudkin, John S. (2012). "Post-marketing observational trials and catastrophic health expenditure". British Medical Journal. 344: e3987. doi:10.1136/bmj.e3987. PMID   22692653. S2CID   206895448 . Retrieved 11 March 2013.
  32. Gulland, Anne. "Top drug companies are making more accessible but are also guilty of corruption, report says". British Medical Journal. Retrieved 28 October 2015.
  33. Gore, Charles; Morin, Sébastien; Røttingen, John-Arne; Kieny, Marie Paule (2023-09-01). "Negotiating public-health intellectual property licensing agreements to increase access to health technologies: an insider's story". BMJ Global Health. 8 (9): e012964. doi: 10.1136/bmjgh-2023-012964 . ISSN   2059-7908. PMC   10496684 . PMID   37669799.
  34. Ali & Narayan, Mohammed K., K.M. Venkat (2008). "The New Access to Medicine Index". The Lancet. 372 (9642): 891. doi:10.1016/S0140-6736(08)61396-3. PMID   18790309. S2CID   36253561 . Retrieved 11 March 2013.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  35. Newsdesk (August 2010). "Bridging the gap in access to medicines" (PDF). The Lancet. 10 (8): 514–515. doi:10.1016/s1473-3099(10)70150-x . Retrieved 11 March 2013.
  36. Morin, Sébastien; Segafredo, Giulia; Piccolis, Manuele; Das, Aditi; Das, Meghmala; Loffredi, Nicola; Larbi, Amina; Mwamelo, Kim; Villanueva, Elena; Nobre, Sandra; Burrone, Esteban (2023-01-01). "Expanding access to biotherapeutics in low-income and middle-income countries through public health non-exclusive voluntary intellectual property licensing: considerations, requirements, and opportunities". The Lancet Global Health. 11 (1): e145–e154. doi:10.1016/S2214-109X(22)00460-0. ISSN   2214-109X.
  37. Connelly, Dawn. "Targeting disease in the developing world". The Pharmaceutical Journal. Retrieved 28 October 2015.
  38. Zhou, Albert E.; Travassos, Mark A. (2022-08-11). "Bringing Sickle-Cell Treatments to Children in Sub-Saharan Africa". New England Journal of Medicine. 387 (6): 488–491. doi: 10.1056/NEJMp2201763 . ISSN   0028-4793.
  39. Edwards; et al. (2015). "Access to hepatitis C medicines". Bulletin of the World Health Organization. 93 (11): 799–805. doi:10.2471/BLT.15.157784. PMC   4622162 . PMID   26549908.
  40. "4 principles for urgent pharma action to combat COVID-19". World Economic Forum. 2021-02-09. Retrieved 2023-12-12.