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November 29, 2012
Pharmaceutical Firms are Improving Access of World's Poor to Medicine
    by Robert Kropp

The 2012 Access to Medicine Index finds that the pharmaceutical industry has improved its performance in delivering products to developing nations, but needs to improve lobbying transparency and oversight of clinical trials.

The 2012 Access to Medicine Index, an important indicator as to whether the world's largest pharmaceutical companies are contributing to the realization of the Millennium Development Goals (MDGs) relating to public health, was published this week by the Netherlands-based Access to Medicine Foundation.

Four of the eight MDGs address health issues in developing nations, "and more than a decade of increased international attention on improving the health of people in the developing world has borne fruit," the Index reports. "The leading pharmaceutical companies have also played a significant role, collaborating with the global health community to address the needs."

The biennial Index ranks the 20 largest pharmaceutical companies in seven major areas: medicine management, public policy and market influence, equitable pricing, patents and licensing, advancement in product development, and philanthropic activities. The goal of such measurements is to increase the availability, accessibility, affordability, and quality of pharmaceutical products for the world's poor.

When the 2010 Index was published, Wim Leereveld, the Chairman of the Access to Medicine Foundation, told that the focus of the Index had shifted from policies to practices. He said, "The most important measurements are management practices, patent and pricing issues, and the research and development pipelines of pharmaceutical companies."

The priority of the Index remains focused in 2012 on practice; and generally, it found, "The industry has made some important advances over the last two years, with the development of simpler and more affordable HIV and malaria diagnostics, and dramatic advances in laboratory-based tuberculosis diagnostic technology. In addition to engaging in innovative research, product development partnerships have made significant progress in adapting existing products."

"Such examples show how large the impacts of pharmaceutical innovation, development and good practice can be," the Index continued, "and it is due to such impacts that pharmaceutical companies have become increasingly important in tackling the MDGs related to health."

As it did in 2010, GlaxoSmithKline ranked first among the 20 pharmaceutical companies in 2012. Since 2010, the Index reports, the firm has "established a Developing Countries and Market Access unit as a department dedicated to access, bringing all its businesses in Least Developed Countries under one umbrella, supported by a new lower price/higher volume business model."

New to the top three in this year's rankings are Johnson & Johnson and Sanofi. Johnson & Johnson "has consolidated its access activities under one business unit, which has resulted in a more strategic and integrated approach, and to its acquisition of Crucell, which has increased the relevance of its research and development investments." And Sanofi has exhibited "strong performance in public policy and market influence, a large investment in research and development and good practice in the management of clinical trials."

Merck was the fastest-rising company in the Index, improving by nine places due to "its detailed disclosure around its tiered pricing schemes."

Among the key findings overall are that more companies are devoting substantial percentages of their product pipelines to products for developing countries, and using tiered pricing schemes for more products and countries. However, the Index found, "The majority of companies provide no evidence of exerting real influence over the way Contract Research Organizations conduct trials on their behalf." Only four companies were shown to use disciplinary measures to ensure that CROs were conducting clinical trials in ethical ways.

Most companies should also improve transparency around their lobbying activities, the Index concluded.

"This year's Index shows that companies are becoming more organized internally in their approach to access to medicine," Leereveld said. "Access to medicine is a multi-faceted challenge and therefore responsibility for improving it lies with a number of different actors, but the pharmaceutical industry has a critical role to play. While the Index shows it has made strides in many areas, companies that have sector-leading practices also show us there is more the industry can contribute."


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