Globally, 2 billion people still cannot access the medicine they need. Among the many stakeholders working to improve this situation, pharmaceutical companies have a crucial role to play. For almost ten years now, the Access to Medicine Foundation has built stakeholder consensus on what we can expect from pharmaceutical companies.
This consensus is distilled every two years into the methodology for the next Access to Medicine Index, with input from experts working across the access-to-medicine field. The metrics at the core of the methodology translate into ambitious, yet achievable expectations for pharmaceutical company behaviour in each area the Index measures.
How we measure
The Index measures companies across seven areas of behaviour – called Technical Areas – that are key for improving access to medicine. When it comes to calculating companies’ overall Index scores, the different areas are given different weightings, reflecting their varying importance for access.
Evolution of the framework
The comparative weights of each Technical Area and each Strategic Pillar are given in percentages (of a company’s final overall Index score). For the 2016 Index, the weighting of the Performance pillar has increased to 50%. For the previous two Indices, its weighting remained static at 40%.
Methodology for the 2016 Access to Medicine Index
In 2016, the Index measured the same 20 companies as in the 2014 iteration: these companies remained the largest R&D-based pharmaceutical companies with the most relevant expertise and portfolios. The geographic scope totaled 107 countries: a handful of countries moved out of scope, as socio-economic conditions improved, while others (Iran, Jamaica, Mexico, Panama and Peru) moved into scope. The disease scope for the 2016 Index comprised 50 conditions and diseases. In 2016, more up-to-date data on disease burdens had become available, bringing three additional non-communicable diseases into scope.
The 2016 Index uses 83 indicators: 6 were new in 2016 and 9 are mergers of pre-existing indicators. 9 indicators from the previous methodology were removed. Changes were made following statistical analyses, either to improve our measurements of company practice, to align with changes in global-health priorities, or to improve efficiencies in analysis and data capture.
Reviewing the methodology
Each Access to Medicine Index is the product of a two-year process known as the ‘Index cycle’, which begins with a review of the Index methodology. This process aligns the Index metrics with changes in access-to-medicine priorities and stakeholder consensus on what we expect from pharmaceutical companies to improve access to medicine. We also use the review to reaffirm the robustness of the next Index analysis, and ensure our capacity for trend analysis is maintained.
In 2016, the review started with a series of indicator-level tests carried out by the Index research team to pinpoint risks of redundancy, where scoring guidelines could be tightened for 2016, and where data quality could be enhanced. The outcomes were used to inform methodology proposals that were also closely informed by stakeholder views. Strategic guidance was provided by the Expert Review Committee (ERC) for the 2016 Access to Medicine Index Methodology Report. The ERC is an independent body of experts from, among others, the WHO, governments, patient organisations, the industry, academia and investors.
Since the first Access to Medicine Index in 2008, members of the Foundation’s Expert Review Committee (ERC) have provided independent, strategic guidance to each review of the Access to Medicine Index methodology. The current ERC is made up of independent experts, including from the WHO, the industry, NGOs, academia and investors. They are all active on the access to medicine agenda and together represent a variety of stakeholder groups. The ERC provides external advice on the scope, structure, and analytical approach of the Access to Medicine Index.
For the 2018 Access to Medicine Index, we are pleased to have Professor Hans Hogerzeil chairing once again, and to welcome five new members: Fumie Griego (Assistant-Director General of the IFPMA), Frasia Karua (Interim General Manager for Amref Enterprises), Yo Takatsuki (BMO Global Asset Management), Joshua Wamboga (Chair-Elect of the International Association of Patient Organisations), and Prashant Yadav (University of Michigan).
Joshua Wamboga Magawa
Sanne Frost Helt
Helena Viñes Fiestas
2017 Methodology for the 2018 Access to Medicine Index
The methodology for the 2018 Access to Medicine Index has now been published. It details the scopes of analysis, the analytical framework and final indicator set for 2018. It also describes the consensus-building process and how the latest cycle shaped the 2018 Access to Medicine Index. The refined methodology has a tighter focus on where companies have the largest potential for impacting access.
To read more about the 2018 Access to Medicine Index Methodology Report, please click here.