Once again, GlaxoSmithKline has topped pharma company medicine accessibility rankings in a biennial global report, out Tuesday.
Compiled by the Access to Medicine Foundation, the report measures how well the largest 20 global Big Pharma companies are making drugs and vaccines accessible to low- and middle-income countries, which account for 83% of the world’s population.
GSK topped the access list for the seventh time—it's done so in every report since its inception—but this year, Novartis cut GSK's lead. Johnson & Johnson ranked third and Pfizer moved into the No. 4 spot for its first time in the top 10, followed by Sanofi rounding out the top five.
And the more encouraging news to the foundation is that eight companies in the report now have an expressed commitment to offer better access.
“What we’ve been trying to do for years is trying to break that strategic view that R&D is meant for Western populations first and then later available for low-income countries,” Jayasree Iyer, executive director of the Access to Medicine Foundation, said.
So it was a welcome surprise in this year’s report, she said, to find a core group of eight companies that have now mainstreamed access planning.
While access may not yet be incorporated into every single project, the group of eight has “taken that step to say ‘We’re no longer going to stand and say our products are not available to low-income markets, but we’re going to make a concerted effort—check. And let’s see how we’re going to do this,’” Iyer said.
The foundation rates the 20 pharma companies' access to medicine across three areas: governance, research and development, and product delivery.
Governance includes measures such as incentives for access that trickle down to the local manager level, compliance violations and sales practices. In research and development, the foundation looks at the strength of a company’s pipeline and its early plans for availability in low- and middle- income countries, but also how well the pipeline matches up with international priorities.
Product delivery measures pharma companies' actions on the ground in getting medicines to local populations—essentially, how well they deliver to countries and patients at the base of the income pyramid.
Pfizer leaped into the top five from its previous 2018 report spot at No. 11. Two years before that, it held No. 14.
“The way the world is looking at Pfizer now and the kind of response Pfizer has had in engagement in low- and middle-income countries is a very big change,” Iyer said.
Pfizer’s rapid COVID-19 vaccine development was one factor in its improved access rating. But it's also improved access to cancer care, added access planning earlier across its R&D efforts and increased the number of countries that receive lower prices—and the number of drugs subject to better pricing, Iyer said.
The pandemic threw an unexpected wrench into every company’s plans and impacted access strategies along with all other planning. Still, Iyer is wary of excuses, especially from U.S. companies, about healthcare access and the impact of pricing pressures.
“We find it kind of remarkable that you have leaders like Johnson & Johnson who face the same kind of pricing pressures, the same kind of concerns about how to address access to health in the U.S., and they perform well compared to companies like Bristol Myers Squibb and Eli Lilly and AbbVie who have the same pressures but perform badly,” she said. “So there must be a way to take care of your domestic population, offer the right amount of access to your domestic population and still keep your commitments globally, and I think that’s important to think about here.”
Glaxo CEO Emma Walmsley said in a news release that the company was "delighted" to top the list again and pointed to the result from the dedicated work of its employees and partners around the world.
"Looking ahead, we remain strongly committed to improving research, access and development of new medicines and vaccines for global health diseases, in particular HIV, TB and malaria, future pandemics and antimicrobial resistance," she said.