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How the companies perform
The scores in this area are getting closer, with one company leading by a clear margin. Nevertheless, there are approximately four densely clustered groups, separated by performances in equitable pricing, filing for registration and brochure and packaging adaptations. More companies are engaging in equitable pricing, and for more products, than in 2014.
Although the scores are closer, the average score in this area has dropped since 2014. Closer scrutiny in equitable pricing and filing for registration has revealed some weaknesses in company practice. The three leaders are GSK, Johnson & Johnson and Novartis – a smaller leading group than in 2014, when six companies were out in front. The top 11 companies remain largely unchanged, although three companies within this group have fallen more than five positions.
Two companies have joined the top ten, each rising ten positions or more (AstraZeneca and Novartis). The five lowest-ranking companies are split into two clusters: the three companies ranked 16th to 18th employ some equitable pricing strategies. These are separated by a large gap from the companies ranked 19th and 20th: Astellas is the only company that has not yet implemented equitable pricing strategies, and Roche did not disclose key information.
The groups are separated by performances in three areas: equitable pricing strategies, filing for registration and the consideration of rational use (brochure and packaging adaptation). The industry does not take sufficient account of patients’ needs and constraints in any of these areas. Regarding accountability for sales agents’ pricing practices and the issuing of drug recalls, companies are closely clustered: they mainly meet basic standards, with few companies standing out.
Leaders prioritise need
All three leaders are frontrunners when it comes to adapting brochures and packaging materials to address the needs of patients and administrators in countries in scope. GSK and Johnson & Johnson are also leaders in equitable pricing, and Novartis is a leader when it comes to filing to register products in countries with a particular need for greater access.
GSK has jumped from 7th place in 2014 to 1st in 2016. It leads in equitable pricing: all of its products with equitable pricing are priced with consideration for socio-economic factors in at least some countries in scope; it uses equitable pricing for more products than any other company in scope; and has the most marketed products with equitable pricing strategies that target countries with a particular need for access to the products in question.*
GSK is also a leader when it comes to facilitating the rational use of its products: it has adapted packaging and brochures to take account of local language, literacy, demographic and environmental needs.
Johnson & Johnson moves from 5th to 2nd place. It is a leader in its consideration of socio-economic factors for inter-country equitable pricing, and in providing price- and volume-of-sales information for countries targeted by its equitable pricing strategies. Two-thirds of its products with inter-country equitable pricing consider socio-economic factors, including economic development, public health need, disease burden, health care situation of the country/region, cost analysis, and the level of out-of-pocket payments. Johnson & Johnson has adapted packaging and brochures to take account of local language, literacy, demographic and environmental needs of patients and at the point of dispensation.
Novartis joins the leaders in 2016. It has risen 10 places into 3rd, making it one of the biggest risers. It has extended equitable pricing to more than twice as many products as in 2014, partly through the Novartis Access programme. It leads in product registration, having filed to register all of its ten newest products in countries with a particular need for access to the product in question.* Novartis is also the leader in facilitating the rational use of its products with a best practice: it has adapted packaging and brochures to take account of all five of the relevant needs identified by the Index (language, literacy, cultural, demographic and environmental considerations) at various levels of the health system, including physicians, pharmacists and patients.
Large middle group
In the upper middle group (4th to 11th place) are Sanofi, Novo Nordisk, Merck KGaA, Gilead, AstraZeneca, Merck & Co., Inc., AbbVie and Bayer. This group delivers mixed performances across the different areas measured: all excel in some areas but lag in others. Most companies in this group were in the top ten in 2014. Five of these companies have fallen since 2014, including the three companies that occupied the top three positions in 2014 (Gilead, AbbVie and NovoNordisk). AstraZeneca is the only company in this group that was not in the top ten in 2014.
AstraZeneca has risen 11 places from 19th in 2014 to 8th in 2016. Compared to 2014, AstraZeneca has significantly increased the number of products with equitable pricing strategies. It has conducted an in-depth analysis of the abilities of different population segments in a subset of countries to pay for its products. The results have been used to shape its new pricing policy, and will continue to inform pricing adjustments. The policy has already been implemented for certain products and countries in scope. AstraZeneca has also created an Affordability Centre of Excellence to train staff on this new policy.
The lower middle group includes Bristol-Myers Squibb, Daiichi Sankyo, Eisai and Pfizer. These companies have low scores across most areas but do not completely lag in any given area (except in their level of accountability for sales agents’ pricing practices). Only Bristol-Myers Squibb was in this group in 2014. Daiichi Sankyo and Pfizer have risen while Eisai has dropped.
Laggards slip in all areas
Ranks 16 to 18 are occupied by Takeda, Eli Lilly and Boehringer Ingelheim. These three fall behind in most areas, but deliver average performances when it comes to facilitating their products’ rational use and drug recalls policies. The lowest two ranks are taken by Astellas and Roche. Astellas has not yet implemented equitable pricing for any products in scope, and does not adapt its brochures or packaging to facilitate products’ rational use. It has also not filed to register any of its ten newest products in any priority countries.* Roche is the biggest faller, dropping nine places since 2014. This is mainly because it has provided the Index with no information in several key areas, including price and volume-of-sales data, registration targets and how it attempts to facilitate the rational use of its products. It has equitable pricing strategies for a limited proportion of its portfolio.
*Priority countries are disease-specific sets of countries with a particular need for access to the products in question. See pages 188-189 of the ATMI report for more information.