The Access to Medicines Foundation, a Dutch NGO has released its biennial Access to Medicines Index for the year 2014, on November 17th, 2014. The Index analysis the top 20 pharmaceutical companies in the world and ranks them according to their efforts in improving Access to Medicines. GSK has emerged on top for the fourth time in a row, followed by Novo Nordisk. Sanofi and Pfizer have fallen most significantly in rankings. (See SpicyIP’s coverage of the 2008 Index here).
The 2014 Report gives an overall optimistic report of the industry by noting that companies are doing increasingly more on the access to medicines front. However, the progress is rather concentrated, with five companies accounting for more than half the relevant drugs in the pipeline, and half the relevant drugs targeting only 5 diseases.
The Index takes into account 7 factors- General Access to Medicine Management, Public Policy and Market Influence, Research and Development, Pricing, Manufacture & Distribution, Patents & Licensing, Capability Advancement and Donations & Philanthropy. The Index has some interesting insights on the R&D, Pricing and Patents & Licensing fronts.
Research & Development
GSK remains the overall leader in the R&D category, scoring the highest for collaborations, IP sharing and innovation. However, more than half of the relevant R&D has been focused on 5 diseases- Diabetes, Lower Respiratory Infections, Hepatitis, HIV/AIDS and malaria. Johnson & Johnson, AbbVie, Merck KGaA, Novartis, GSK and Sanofi contribute to more than 50% of all R&D for the relevant drugs.
The Index also commends the rise of new partnership models that draw on public and private funds to pool R&D risks and share benefits. However, not all these partnerships focus on improving access. GSK is commended for including access provisions in research contracts for a range of diseases including neglected tropical diseases. Takeda is also commended for collaborating with TB Alliance, Medicines for Malaria Venture and the Drugs for Neglected Diseases Initiative.
Pricing, Manufacture and Distribution
Gilead leads the pack when it comes to equitable pricing strategies, both intra-country and inter-country. AbbVie comes in second place. Merck, Bayer and Novo Nordisk are commended for innovation in pricing, manufacture and distribution. For example, Novo Nordisk has reduced the price of a single vial of insulin to just 12% more than the unit cost, and it also offers the insulin delivery service free of charge. Overall, compared to 2012, more companies are disclosing a stronger commitment to equitable pricing.
Neglected tropical diseases are subject to the least initiatives in equitable pricing (perhaps because these drugs are often distributed through mass donation programmes). There is also a gap in equitable pricing strategies for non-communicable diseases (such as schizophrenia, epilepsy and diabetes) which is not as easily explainable.
Patents & Licensing
Compared to the other indicators, company performance was found to be low in the Patents & Licensing front. However, Gilead and GSK lead this category, largely because of their licensing practices (bilaterally and through the Medicines Patent Pool). GSK and Pfizer’s efforts in the joint venture to create the company ViiV which focuses on HIV drugs, and the license practices adopted by ViiV, were highlighted. Gilead has licensed 80% of its relevant patented products, with more than 60 licenses for its HIV products.
Roche and MercK stood out for pledging not to enforce patents in any Least Developed, low income and lower-middle income country. Astellas, Gilead, Pfizer and Takeda performed poorly in this regard, for making no commitment even with respect to Least Developed Countries.
The Index also took into account the Companies’ stance on the TRIPS agreement and the Doha Declaration on Public Health. It found that very few companies explicitly endorse TRIPS flexibilities (GSK, Eisai and Eli Lilly being exceptions). Novartis and Bayer’s involvement in the S.3(d) and Compulsory Licensing disputes respectively in India counted against them in this regard.
The Report is an overall interesting read as it gives insight into the particular strategies that the different pharma companies adopt. It also highlights the shortcomings of the industry as a whole (such as in the concentration of R&D towards 5 diseases) and the failures of particular companies in different fields. It will help activists and others take more nuanced stances in their efforts towards fighting for greater Access to Medicines.