Which Pharma Companies Provide Access to Poor?

Which Pharma Companies Provide Access to Poor?

November 28th, 2012 // 5:07 pm @


There is a metric for everything. So why not a metric for gauging which drugmakers are doing a good job of providing medicines to those in the poorest countries? This is what the Access to Medicine Foundation does every two years and its latest ranking shows that GlaxoSmithKline has come out on top. Moreover, the latest index also finds that big pharma is doing more for access to medicine in developing countries than two years ago.

The overall improvement follows – perhaps, not coincidentally – more than a decade of negative headlines over a raft of contentious issues, from fights with various governments over patents rights and pricing in developing countries, to growing concerns over unreleased clinical trial data and large settlements over improper promotional practices. For this reason, the index is a closely watched barometer for those in and out of industry.

Overall, 17 of the 20 large drugmakers ranked are doing a better than at the time of the last index report in 2010. And the gap has also narrowed between those at the bottom of the ranking and the top performers. In general, there are more drug developed for more diseases that affect the world’s poor and more collaborations. And some have devoted as much as 20 percent of their pipeline to developing products that address the needs of the poor.

But the foundation says there are “still several areas where all companies could improve their approaches significantly.” These include more transparency about lobbying practices, expanding tiered pricing schemes, adapting packaging to local needs, making drug donations based on needs and allowing clinical trial data to be used to accelerate the approval of generic medicines in developing countries.

But drugmakers fall short when it comes to the use of contract research organizations to run clinical trials. Not one drugmaker is “publicly transparent” about the CROs that are hired. “Accountability involves ensuring the well-being of trial participants through adequate due diligence in selecting these contractors, monitoring how they conduct the trials and willingness to enforce codes of conduct with disciplinary action,” the foundation reports (you can also see the chart here – the orange bar is for product donations and philanthropic activities).

The issue highlights ongoing concerns about the growing amount of clinical trial work taking place in developing countries, where the cost are lower, but ethical considerations are regularly raised. High on the list – the treatment of trial participants when experimental medicines cause complications and the extent to which patients in those countries are later allowed access to the medications.

Only four drugmakers – Merck (MRK), Sanofi (SNY), Glaxo (GSK) and Eisai – provided evidence that they use disciplinary measures to enforce codes of conduct with their CROs to ensure that trials of their products are conducted safely and ethically, the foundation writes in its report. As a result, the foundation scolds the industry for a level of accountability that is far from meeting expectations (here is the complete report).

For those keeping score of individual drugmakers, the foundation noted that Johnson & Johnson (JNJ) jumped to the No. 2 position from No. 9 thanks to a couple of moves – the consolidation of its access activities under one business unit, which has resulted in a more strategic and integrated approach, greater disclosure, and the acquisition of the Crucell vaccine maker, which increased the relevance of its R&D development investments.

As the chart indicates, the drugmakers that rose in rank the most were Merck KGaA, followed by J&J and then Bayer. AstraZeneca fell down the rankings most significantly, followed by Boehringer-Ingelheim, then Novartis and Roche. The bottom of the pack is dominated by Japanese drugmakers – Takeda, Daiichi and Astellas – although it is not immediately clear why this is the case.

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