Big pharma steps up access, but uneven progress made: report

Licensing of COVID-19 treatments has shifted to include other medicines and treatment areas | World’s largest pharma companies still “consistently overlook the poorest countries” | Report offers strategy to improve access.

Since the COVID-19 pandemic, more pharmaceutical companies have made their products more widely accessible, but progress has been uneven, with low-income countries widely overlooked.

This is according to a “ 2022 Access to Medicine Index” from the Access to Medicine Foundation released yesterday, 15 November.

The non-profit organisation found that, for the first time, all 20 companies reviewed reported an access-to-medicine strategy, with 19 integrating it into their overall corporate strategy. GSK, Johnson & Johnson, AstraZeneca and Novartis "emerged as clear leaders” in addressing access, said the report.

To improve access, companies are using strategies such as voluntary licensing—which makes on-patent products available for generic manufacturing—and access plans, which allow those in low- and middle-income countries to gain access to products more rapidly and affordably following their market entry.

Six companies – Astellas, Boehringer Ingelheim, Johnson & Johnson, Merck, Novartis, and Takeda – now have access plans in place for all of their late-stage R&D projects. This is the first time any of the 20 companies have reached this milestone.

COVID-19 prompts open licensing of other medicines

The growth of voluntary licensing has been driven by companies engaging in voluntary licensing for COVID-19 products.

But, the Access to Medicine Foundation is confident that this will open the door for more companies to consider entering into licences for a wider range of medicines.

Novartis’ non-exclusive voluntary licence for a leukaemia medicine with the Medicines Patent Pool—the first such agreement covering a non-communicable disease—is significant, added the report.

However, while companies are taking steps to improve access in low- and middle-income countries, their plans and strategies “consistently overlook the poorest countries”, warned the report.

It added: “Analysis of companies’ access plans and strategies shows that they are often limited in depth and breadth, sometimes only containing the most basic elements. As ever, low-income countries are paid the least attention.”

According to the analysis, although there has been an industry-wide expansion of access planning during the R&D stage, the number of countries included in plans is low.

An access plan, on average, includes only six of the 108 countries in scope of the index and only 15% of access plans include at least one of the 27 low-income countries.

However, 85% of the access plans include at least one of the 26 upper-middle income countries, with upper-middle income countries being six times more likely to be included in companies’ access plans for an R&D project.

The report acknowledged that expanding access in low-income countries can present complex challenges for companies, such as a lack of regulatory capacity, weak healthcare infrastructure, or being less likely to provide a high-yielding market.

“Even though there is no ‘one-size-fits-all-products’ approach, companies can utilise a wide range of tools and approaches to directly address access and affordability in low- and middle-income countries,” said the report, suggesting strategies including equitable pricing strategies and non-exclusive voluntary licensing agreements o facilitate an increase in generic supply.

The report noted: “As the world emerges from the worst of the COVID-19 crisis, pharmaceutical companies are now at an important juncture, where lessons learned from the pandemic can prove pivotal in finding solutions to bridge long-standing gaps in access to medicine in low-and middle-income countries.”

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