Top drug developers are “inching ahead” in improving access to much-needed drugs around the world — an issue that has been underscored by the Covid-19 pandemic. But there’s still more work to do, Access to Medicine Foundation executive director Jayasree Iyer said.
Every two years, the Access to Medicines Index ranks the top 20 biotechs leading the push for better access to medicines in low- and middle-income countries. This year’s report, published Tuesday, looks at drug access in 106 countries.
GlaxoSmithKline led the pack for another year, closely trailed by Novartis. Johnson & Johnson ranked third, with Pfizer and Sanofi right behind it.
But although companies are “inching ahead” in their efforts, we’re still far from where we need to be, Iyer said in a statement.
“… Activity still concentrates on too few diseases and too few countries, thus benefiting only a fraction of the people in need,” Iyer said. “What is more, most of the effort is being made by only a small number of firms, creating a fragile situation where any retreat could have dire consequences.”
The rankings were published as reports emerge that it could be years before those in low-income countries get Covid-19 vaccines. Last month, Reuters accessed internal papers regarding the WHO, CEPI and Gavi-led COVAX program that warned a lack of funds, supply risks and complex contractual arrangements could leave those in poor nations without vaccines until 2024.
“Too many people lack access to innovative health products emerging from R&D pipelines,” Iyer said.
In a statement, she encouraged companies to “become a catalyst, not a barrier” to equitable drug access. And the industry appears to be moving in the right direction.
Eight of the 20 companies ranked in the index are now developing systematic approaches to access planning — a vast increase from the single company doing so (Novartis) when the last report came out in 2018. But that still leaves 12 companies without strategies for better access. And less than half of key products controlled by the 20 companies are offered through access strategies in lower-middle or low-income countries.
To take a closer look, the foundation zeroed in on 199 medicines, vaccines, diagnostics and vector control products deemed “essential for a well-functioning healthcare system.” Of those, only 13% of products that need to be administered by health care professionals (like injectable treatments for cancer) are covered by access strategies in at least one low-income country. And for self-administered meds (like pills) that number is 26%, according to the index.
Just under half (42%) of the self-administered and professionally administered products weren’t tied to access strategies in any of the 106 countries the index evaluated.
“This reveals a widespread lack of consideration for how people living in these countries will gain access to these products, which are largely controlled by the pharmaceutical companies in question,” the report states.
The company with the most candidates covered by access plans is GSK, which has committed to developing access plans for all projects that yield positive Phase II results. Pfizer, which ranked third for most candidates covered by access strategies, begins such planning for all products two years before launch, according to the foundation.
While such initiatives are a step in the right direction, the foundation pointed out that only small numbers of people per country are benefiting from them.
“After years of encouraging access planning, we are now seeing a strategic shift in this direction by pharma companies. This could radically change how fast access to new products is achieved — if company leadership is determined to ensure people living in low- and middle-income countries are not last in line,” Iyer said.