Sunday December 2, 2012, 10:00 am
Guardian Global Development
Big Pharma ups its game in providing drugs to people in poor countries

Access to Medicines Index shows pharmaceutical companies improving on pricing, neglected diseases, lobbying and trials

Sarah Boseley, health editor
guardian.co.uk, Wednesday 28 November 2012 02.00 EST

MDG : Bangladesh : Drug factory and drug maker : Workers on the production line
Workers package drugs on a production line in Dhaka. Big Pharma is addressing its poor image in the developing world. Photograph: Tomohiro Ohsumi/Getty Images
Name

Score 2012

Ranking 2012

Ranking 2010
GlaxoSmithKline plc 3.8 1 1
Johnson & Johnson 3.6 2 9
Sanofi 3.2 3 5
Merck & Co. Inc 3.1 4 2
Gilead Sciences 3 5 4
Novo Nordisk A/S 3 6 8
Novartis 2.9 7 3
Merck KGaA 2.5 8 17
Bayer AG 2.4 9 14
Roche Holding Ltd 2.3 10 6
Pfizer Inc 2.2 11 11
Bristol-Myers Squibb Co 2.1 12 15
Abbott Laboratories Inc 2 13 10
Eli Lilly & Co 2 14 13
Eisai Co. Ltd 1.9 15 16
AstraZeneca plc 1.6 16 7
Boehringer-Ingelheim 1.5 17 12
Takeda Pharmaceutical co 1.1 18 18
Daiichi Sanyko Co. Ltd 0.9 19 20
Astellas Pharma Inc 0.9 20 19

Pharmaceutical companies are doing more to help people in developing countries obtain the drugs they need, according to the latest Access to Medicines Index.

Big Pharma appears to have concluded, after years of bad publicity and allegations that it was greedy and uncaring in pursuit of profit, that it needs to change its practices in the developing world – or at least public perceptions.

While British drugmaker GlaxoSmithKline (GSK), whose chief executive Sir Andrew Witty has announced moves to increase access to medicines in the developing world, continues to top the league table, its lead on the rest has shrunk. Two other major pharmaceutical companies, Johnson & Johnson and the vaccine manufacturer Sanofi, are now close behind.

The index ranks 20 leading pharmaceutical companies and is published every two years by the Netherlands-based non-profit Access to Medicines Foundation. It has become an authoritative guide, with input from the World Health Organisation, governments, universities, NGOs and institutional investors.

Drug companies are scored on a range of measures, from their willingness to discount prices in poor countries, to research on neglected diseases of poor people to lobbying, transparency and conduct in clinical trials.

This is the third index and it finds a much greater focus on drug access within drug companies – where it is now often an issue for the board.

"This year's index shows that companies are becoming more organised internally in their approach to access to medicine and that those who do this best tend to perform well across the other aspects we measure. The leaders are really raising the bar," said Wim Leereveld, founder of the index. "It's also clear that companies that do not continue to step up their efforts tend to be overtaken by their peers."

Although there has been improvement and a greater willingness among companies to change their business practices, it is not yet enough. More companies are using tiered pricing – offering a discount for poorer countries – for a broader range of products, "but it is unclear whether the price reductions are enough to meaningfully increase affordability", says the report.

Only five companies varied their pricing in 2010 but 12 did it this year. Yet they do not always disclose the full extent of the reduction nor take account of mark-ups by sales agents within a country. The best performer on tiered pricing is Gilead Sciences, which makes some of the leading Aids drugs. GSK has fallen to second place for a number of reasons, including reducing prices in fewer countries than Gilead.

More companies are researching and developing medicines for diseases of poor countries. Some now have as much as 20% of their pipeline – drugs they are in the process of researching which one day will get to market – devoted to them.

But there are concerns that Big Pharma is not demonstrating real influence over the private contractors it now increasingly uses to carry out drug trials in the developing world. No company is publicly transparent about all the Contract Research Organisations (CROs) it employs, says the report. The foundation says companies must ensure they hold these CROs to account for ensuring the wellbeing of volunteers in trials and conducting the trial scrupulously. Only four companies – Merck and Co, Sanofi, GSK and Eisai – provided evidence to show that they could and would use disciplinary measures to ensure CROs carried out trials in a safe and ethical manner.

"Access to medicine is a multi-faceted challenge and therefore responsibility for improving it lies with a number of different actors, but the pharmaceutical industry has a critical role to play. While the index shows it has made strides in many areas, companies that have sector-leading practices also show us there is more the industry can contribute," Leereveld said.

Sunday December 2, 2012, 10:51 am
The GMO labeling campaign should include pharmaceuticals. How does something that causes organ failure become a healing component? It's a violation of the Gippocratic Oath, first cause no harm.... do doctors still tKe that oath or is there a caveat for drugs?

Sunday December 2, 2012, 10:58 am
Good questions Roseann. Sometimes asking the right question is more important than answers. You cannot currently send a star to Roseann because you have done so within the last week.

Sunday December 2, 2012, 9:33 pm
Good to hear. It's insane to see some drug companies that develop the only drug for a certain problem drive their prices up to insane amounts, just because they can knowing that people can't function without the medication they are selling. Unfortunately Roseann doctors do not take the oath. The oath is more of 'guidelines' and is quite outdated. However, all doctors are licensed and etc so that is essentially the new 'oath'.

Sunday December 2, 2012, 9:38 pm
You cannot currently send a star to Rebecca because you have done so within the last week.

Tuesday December 4, 2012, 12:34 am
Thanks J.L. A.

Tuesday December 4, 2012, 2:26 am
I agree with you Roseann about the GMO labeling! I realized the iron I was prescribed by my doctor was made from soy, I wrote to the manufacturer but never received a response, so I found a different iron not made from soy.
Regarding your question "How does something that causes organ failure become a healing component?"
You need to consider the alternative. People who undergo organ transplant must take medication that suppresses their immune system, for life!
A person needs to be informed of the risks along with the benefits when prescribed medication!

Tuesday December 4, 2012, 4:04 am
noted......Pharmakeia φαρμακεια is the Greek word for pharmacy, which is the practice and making of medication and vitamins.[citation needed] It also refers to the making of spell-giving potions, or alchemical potions (or elixirs) believed to have transforming powers, such as the power to extend life, boost energy, or enhance the mind. It also refers to any substance used to poison someone, to prevent or treat disease (or, for that matter, to cause it), or to gain control of someone's behavior. [1][unreliable source?] Pharmakeia and its related word forms pharmakeus, pharmakon, pharmakos and pharmakoi are the words from which we get the modern English words pharmacy, pharmaceutics, pharmaceutical, pharmacist, pharmacopia, pharmacology, pharmaceuticalist and pharmaceuticalism. The modern transliteration of pharmakeia is pharmacia. Pharmakeia and its related forms appear several times in the New Testament, including the Epistle to the Galatians and the Book of Revelation. It is frequently translated as "witchcraft" or "sorcery".[2][unreliable source?]Magical pharmacia substances or potions often bind someone under a spell by evocation with and without uttered word formulas.......................evil, and they are the companies with the most money on earth, wonder why?..........:))

Tuesday December 4, 2012, 4:17 am
If big pharma helps everyone in the world there will still be Americans who die because they can't even afford a check up once a year.

Tuesday December 4, 2012, 4:18 am
Noted. Thanks J.L. The drug companies are really very powerful and are getting stronger and stronger as medicine advances.

Tuesday December 4, 2012, 4:34 am
Noted, can see the difficulty, my 2 medacines cost approximately $6,000 per month.

Tuesday December 4, 2012, 6:57 am
You are welcome Robert.
Thanks for the mini-history and etymology lessons Frans--really helps frame the issue effectively! (especially with what Shalvah said).You cannot currently send a star to Frans because you have done so within the last week.
Sadly true--part of what health care reform is supposed to address. You cannot currently send a star to Gloria because you have done so within the last week.
That is indeed one concern Giana. You cannot currently send a star to Giana because you have done so within the last week.
You cannot currently send a star to John because you have done so within the last week.

Tuesday December 4, 2012, 1:35 pm
I agree about the GMO labeling ! I'm sure the medication in poor countries is different from what we get. Once in Asia I got given huge blue pills, tasting very bitter; I believe it was some sort of " horse tranquilizer". The Western medicine is more sofisticated and advanced.

Tuesday December 4, 2012, 2:26 pm
You cannot currently send a star to monka because you have done so within the last week.

Tuesday December 4, 2012, 7:27 pm
Glad we in Canada only pay a small amount for our medication , according to our income, I would be in the poor house right now !

Tuesday December 4, 2012, 7:36 pm
You cannot currently send a star to Aletta because you have done so within the last week.

Wednesday December 5, 2012, 6:43 pm
Thanks.

Wednesday December 5, 2012, 9:19 pm
You are welcome greenplanet.