What is the Access to Medicine Index?

2 billion people in the world have no access to medicine. The Index gives insight into what the pharmaceutical industry is doing to improve this situation.

The Access to Medicine Index independently ranks pharmaceutical companies’ efforts to improve access to medicine in developing countries. Funded by the Bill & Melinda Gates Foundation and the UK and Dutch governments, the Index has been published every two years since 2008.

The access to medicine problem is multifaceted, and responsibility for tackling it lies with many different actors – governments, NGOs, academia, pharmaceutical companies, finance institutions and multilateral organisations such as the WHO. As manufacturers and developers of life-saving products, pharmaceutical companies clearly have a crucial role to play.

The Index publicly recognises companies for their investments in access to medicine, raising awareness of relevant issues within pharmaceutical companies and providing them with a transparent means by which they can assess, monitor and improve their own performance as well as their public and investment profiles. Consistent iterations of the Index highlight industry trends and provide a basis for multi-stakeholder dialogue and solution building.

The first Access to Medicine Index was published in 2008 on the initiative of Dutch entrepreneur Wim Leereveld. His experience when working with the pharmaceutical industry had taught him that simply ‘naming and shaming’ the industry did not encourage big pharma to play their part. Instead, he decided, it was time to recognise good practice within the pharmaceutical industry by developing a ratings system to show which companies do the most to improve access to medicine and how.

The Access to Medicine Index uses a weighted analytical framework to consistently capture and compare data from the top 20 research-based pharmaceutical companies across a set of countries, diseases, and product types. For each successive Index, relevant stakeholder group representatives help to refine this framework to ensure that it remains up to date with respect to global health priorities. The framework is constructed along seven areas of focus, which cover the range of company business activities that experts consider most relevant to access to medicine. Within each area, the Index assesses four aspects of company action: commitment, transparency, performance and innovation.

The Index Cycle

The Access to Medicine Index requires a robust preparation process to measure big pharma’s role in the dynamic access to medicine landscape.

The Access to Medicine Index is a product of a two-year process known as the ‘Index cycle’. During year one of the cycle, the Foundation focuses on reviewing the previous Index and consulting expert stakeholders to prepare the methodology for the next Access to Medicine Index. Year two is spent collecting, verifying and analysing data from pharmaceutical companies. Finally, the results are published in a new Access to Medicine Index, and the cycle begins again.

After the publication of each Access to Medicine Index, we conduct a thorough review of Index content and the processes behind it. Aside from the Foundation’s own internal evaluation, we also invite stakeholders and the public to give their input through multiple feedback channels. A guiding principle when incorporating feedback is to ensure that the next Index reflects evolving access to medicine priorities, whilst maintaining consistency with the previous iterations for comparison purposes.

The Foundation integrates both technical expertise and stakeholder expectations in each successive Index methodology. The Expert Review Committee (ERC), which functions as the strategic advisory committee for the Index methodology, meets several times during year one of the Index cycle to help define what matters in access to medicine and how we will measure it in the upcoming Index. To complement the work of the ERC, leading experts convene as Technical Subcommittees to provide us with their feedback in specific areas of the methodology.

The Foundation hosts several events over the course of the Index cycle to gain insights on diverse perspectives and developments in the access to medicine landscape. These events range from single stakeholder group consultations to expert meetings, all with a focus on big pharma’s role in access to medicine. Additionally, we participate in relevant round tables and conferences to contribute to the dialogue on access to medicine issues.

The Foundation’s main task during year two of the Index cycle is to prepare the next Access to Medicine Index. We collect, verify and analyse data submitted by the world’s top pharmaceutical companies. The Foundation then publishes the ranking, key findings and insights in the Access to Medicine Index.

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