GSK tops the Index for the fourth time. This is driven by a sturdy performance across most areas, with several innovative practices. It has an innovative business model focused on Africa, a sizable relevant portfolio, a big talk about of its pipeline dedicated to relevant diseases, and numerous access-oriented intellectual property writing partnerships. Novo Nordisk has made the most improvement, improving in five of the seven areas the Index targets. This has resulted in a remarkable leap from 6th to 2nd place, which is partly due to the fact that its access activities are well handled, integrated into its business strategy, and well targeted to local needs. It also applies access-oriented prices ways of diabetes products in every Least Developed Countries.
Sanofi and Pfizer dropped down the ranks most significantly, while Astellas, Daiichi Takeda, and Sankyo stay in the bottom of the league. Wim Leereveld, founder and CEO of the Access to Medicine Index. It scores companies on their performance, innovation, transparency, and commitments across seven areas of activity considered key to improving access to medicine. The ongoing companies are graded on 95 factors covering these areas, including product development and research, to what extent they facilitate or resist efforts to generate generic versions of their drugs, and exactly how they approach pricing in developing countries. Lobbying activities, marketing ethics and product donations and other philanthropic activities are examined also. Jayasree K. Iyer, Head of Research at the Access to Medicine Index.
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Lower respiratory infections, diabetes, cirrhosis of the liver organ (hepatitis), HIV/AIDS, and malaria are receiving the most attention from companies overall, while maternal and neonatal health conditions get relatively less attention, Iyer said. She added that neglected tropical diseases are less neglected than they were two years ago, with a scaling up of donation programs and a handful of new medication development projects, some in partnership with international organizations. The industry has stepped up its efforts on several fronts.
For instance, it is paying more focus on socioeconomic factors, such as people’s ability to pay, tailoring prices within countries progressively. Since 2012, the amount of products in the pipeline appropriate for developing countries is continuing to grow by 47. More companies are experimenting with innovative access-oriented business models; three have released new models and three have extended pilots. Companies are granting more licenses to developing country companies to make and disperse generic variations of their medicines. Meanwhile, plans and activities to improve access to medication continue to get better organized.
However, improvement is uneven over the areas of activity that matter, with the industry battling to perform well in two important areas. Firstly, almost all companies (18) have been the main topic of settlements or judgements regarding breaches in moral marketing, bribery, or corruption criteria or competition laws and regulations in the last two years.
During the period of analysis there have been high-profile allegations of corrupt practices against several companies working in China. The full case against GSK, one of those companies, was settled following the period of analysis and therefore did not impact its rating in the 2014 Index. Breaches captured in this Index range between paying or elsewhere inappropriately incentivising doctors to prescribe their products, to collusions delaying market entry of generic medicines and misrepresenting the efficacy and safety of their products or those of their competitors.
The Index’s analysis reveals there is absolutely no direct relationship between a company’s size, the breadth of its geographical footprint, and its own occurrence of breaches, which signifies that breaches are not just a cost to do business. This evidence raises questions within the commitment and effectiveness of company governance of this area.
Secondly, companies remain conservative in their disclosure of where patents are active and when they’ll expire – information that is very helpful to medication procurers and generics manufacturers. Within the reporting period, no company independently and disclosed patent statuses for products relevant to the Index publicly. Pharmaceutical company research and development (R&D) are a crucial element of enhancing access to medicine. The 2014 Index discloses how focused the relevant R&D is. Just five companies are developing 54% of the 327 products in the offing. All disease classes are being targeted, but over fifty percent of the products under development focus on just five diseases: lower respiratory attacks, diabetes, hepatitis, HIV/AIDS, and malaria.
About 36% of the pipeline targets non-communicable diseases, which are becoming increasingly important in developing countries. Encouragingly, 83% of the reach the stage of development where these are being tested on people, but plans to make them available are limited. Pricing approaches for them are also limited, and lag behind those for most communicable diseases. More than half of the companies are developing “child-size” medicines, as liquids, chewable tablets, child-appropriate doses, or new formulations.