General Access to Medicine Management

How the companies perform

This is a relatively high-scoring area. The top five companies are close to matching stakeholders’ expectations: five companies now score more than four points, with the clear leader close to achieving the full five. Scores fall gradually toward the lower end of the ranking: the higher-ranked companies take increasingly refined approaches to improving access to medicine.

Companies continue to improve in General Access to Medicine Management. Most companies have taken some steps to improve the ways the organise and coordinate efforts to improve access to medicine. Most companies have detailed access to medicine strategies. Companies are developing innovative ideas for improving access: in their business models, approaches to governance, stakeholder engagement and performance management systems.

Leaders are innovators

The leading five companies are led by Novartis, which scores close to the full five points, then Novo Nordisk, GSK, Merck & Co., Inc. and AstraZeneca, which all score more than four. These five companies are top performers in all areas. One of the main differentiators is in innovations. Novartis, Novo Nordisk and AstraZeneca all report promising business models or approaches to governance. AstraZeneca is the biggest riser in this area. It has climbed nine positions, from 14th to 5th, due to large improvements in its strategy, performance management tools and stakeholder engagement processes.

Novartis meets almost all criteria looked for by the Index. Its access-to-medicine strategy supports its corporate strategy, indicating that access-to-medicine is seen as a business driver. Novartis is implementing two promising new business models and has developed an innovative tool for measuring the environmental, social and economic impact of its business in financial terms. In key areas, it meets the highest criteria looked for by the Index: it has a strong performance management system, with clear targets and both financial and non-financial incentives, and it takes a strategic approach to stakeholder engagement, considering the perspectives of local stakeholders, and is transparent about the outcomes.

Novo Nordisk once again performs well in this area. It has strengths in all areas of measurement, only dipping when it comes to the innovativeness of its new business models and the transparency of its stakeholder engagement processes. GSK loses first position, but remains in the top three. Compared to 2014, it did not score in innovation.

Followers do not keep pace

The top five are followed by an upper-middle group of six: Johnson & Johnson, Sanofi, Eisai, Eli Lilly, Merck KGaA and Bayer. The rankings of these companies have largely not changed, with the exception of Merck KGaA. It has fallen from 6th to 10th: its performance has remained static while peers have improved.

Companies in this group score relatively well. For example, Eisai has a solid system in place to manage its access-related performance, but falls behind in innovation. Bayer has above-average performance across all areas but does not engage with local stakeholders in a structured way.

There are some areas where these companies do not keep pace with the leaders: namely, in the incentives structures they have in place linked to access-related targets, and the level at which they assign responsibility for access activities (at executive level, rather than board-level).

Mixed performances at lower ranks

The lower-middle group also includes six companies: Gilead, Pfizer, Boehringer Ingelheim, Bristol-Myers Squibb, Takeda and AbbVie. These companies deliver a mixed performance overall, and their rankings in this area have largely not changed. A common area of weakness is the transparency of their stakeholder engagement activities and approaches. Some companies also have limited or no incentive structures to reward the achievement of access-related targets, and are less innovative. Boehringer Ingelheim stands out for working consistently on innovative business models: it has a unique, best-practice incubator model for developing and rolling-out pilots.

Takeda improves its performance in this area, with a new access-to-medicine strategy. Its stakeholder engagement performance is still relatively low. AbbVie is one of the few companies that still does not have a comprehensive strategy for increasing access to medicine. It does use a series of strategic approaches to make its medicines accessible, yet these approaches are not joined up into an overarching strategy.

Laggards left behind

There are three companies that clearly lag behind: Astellas, Roche and Daiichi Sankyo. Neither Astellas nor Daiichi Sankyo have a clear access strategy, they perform poorly in stakeholder engagement, and in management processes for increasing access to medicine. They also provide less evidence of innovation. Roche’s ranking is affected by an overall lack of transparency across several areas of measurement.

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