Pharma industry faces call to expand patient access in low- and middle-income countries

The pharmaceutical industry is under pressure to ensure that vital health products are accessible to all, regardless of geographic location or socioeconomic status. A new report from the Access to Medicine Foundation provides an analysis of how some of the largest pharmaceutical companies are working to reach patients worldwide, particularly in low- and middle-income countries (LMICs), in pursuit of health equity. The report evaluates their current approaches for measuring and reporting patient reach, emphasizing the need for more actionable strategies to improve access to essential healthcare products.

The report was conducted ahead of the 2024 Access to Medicine Index and examined patient reach commitments and measurement approaches of 20 companies that will be ranked in the Index, set for release in November. The analysis found 42 unique approaches to measuring patient reach across these companies, with some companies using more comprehensive methods than others. Notably, AstraZeneca, Novartis, and Roche are developing more advanced frameworks that go beyond sales tracking to enhance the accuracy of patient reach calculations.

Many companies have set ambitious goals to expand access to healthcare in LMICs. However, the report reveals that these goals often lack the precision needed to achieve meaningful impact. Despite comprising 80% of the global population, people in LMICs face significant barriers in accessing essential healthcare products. The growing demand for these products in underserved regions, coupled with limited availability due to production by a few companies, underscores the need for pharmaceutical companies to optimize their efforts and focus on how many patients are benefiting from their products.

The Foundation’s report highlights that 19 out of 20 companies assessed have approaches to track patient reach in LMICs, with AbbVie as the exception. However, the absence of a standard method for calculating the number of patients reached has led to wide variations in approaches. Only six companies—Astellas, AstraZeneca, MSD, Novartis, Pfizer, and one company under non-disclosure—reported patient reach methods that cover all countries in which they operate.

Pharmaceutical companies have made public commitments to expand global patient reach, particularly in LMICs, focusing on a variety of diseases. Companies like Bayer, GSK, and Johnson & Johnson have set clear and measurable targets aligned with global disease burdens. However, the report points out that significant room for improvement remains, particularly for major insulin manufacturers Eli Lilly, Novo Nordisk, and Sanofi. These companies, which control over 90% of the market, collectively address only 1% of diabetes cases in the 113 LMICs within the Index’s scope, despite the high prevalence of diabetes in these regions.

The report concludes with a call for pharmaceutical companies to turn their commitments into tangible impact. The Foundation outlines ways companies can improve their approaches to patient reach by learning from existing models and collaborating with others. It stresses the importance of embedding patient reach at the core of business operations to address health inequity and avoid leaving underserved populations behind. Companies must also take concrete actions, such as registering products, implementing affordable pricing strategies, and ensuring sustainable supply.

“Companies must prioritise patient reach or risk falling short in addressing health inequity. Our findings lay out a clear path for pharma companies to do this, emphasising how they can embed equitable access within their business operations,” said Claudia Martínez, Head of Research at the Access to Medicine Foundation.

The report draws from companies’ data submissions for the 2024 Access to Medicine Index, as well as public data and inputs from stakeholder consultations. It aims to provide a comprehensive overview of the current industry practices and offers recommendations for strengthening efforts to reach underserved populations with essential healthcare products.