Access to Medicine Index Problem Statement Long-standing debate about: What is the role of the pharmaceutical industry in access to medicines? Where are the gaps in understanding their current role? What are considered best- practices of companies with respect to access to medicines?

The Access to Medicine Index was established in 2005 to take an inclusive and collective approach to defining the role of the pharmaceutical industry through dialogue and consultation with all major stakeholders including the industry itself. Access to Medicine Index A New Approach to these Problems The Index attempts to establish best practices for companies’ behaviour and to rank company policies and practices based on the established criteria.

Access to Medicine Index 2010 Aims and Study Questions The Index aims to: Facilitate and inform dialogue among the stakeholders on access to medicine Function as a learning tool for the industry through establishing and describing best practices Motivate competition among the pharmaceutical companies – through the ranking process – along the 4 strategic dimensions Serve as a decision support tool for other stakeholders which interact and collaborate with pharmaceutical co’s.

Access to Medicine Index 2010 Study Objectives This poster presents the process and the challenges involved in designing methodology and measuring companies for the Access to Medicine Index. Two main areas of challenge are faced: 1.How to design a process in which a diverse array of stakeholders can constructively contribute to building a framework? 2.How to ensure a fair and meaningful assessment and comparison between companies?

Access to Medicine Index 2010 Methods Framework structure: 107 indicators are used to assess the companies Structured along 2 axes of analysis Scope & study poulation: 20 largest pharmaceutical companies Data from the 2008 & 2009 Financial Year’s Policies & activities accross 88 countries & 33 diseases.

Access to Medicine Index 2012 Study Objectives

Access to Medicine Index 2010 Results: measuring and comparing Having established the revised assessment framework… …how to ensure a fair and meaningful assessment and comparison between companies? Especially when there exist: 1.Variability in business models 2.High correlation between indicators? 3.Relative absence of performance data? 4.Data provision in different units and structures? 5.Challenges in measuring impact on relieving social burden?

Access to Medicine Index 2010 Results: measuring and comparing 1.Variability in business models and how to reflect it in the scoring process? Several performance indicator scores were adjusted based on scale indicators including: – Pharmaceutical revenues – Market capital – Size of research pipeline Also % of revenues from originator and generics sales was an additional weight adjustment. ‘Portfolio breadth’ adjustments were removed in Index 2010 : ‘All companies’ contributions to access to medicines should be evaluated on the same weighting of criteria’.

Access to Medicine Index 2010 Results: measuring and comparing 2.How to handle high correlation between transparency and performance indicators? Strategic pillars ensure the Index provides rankings along the areas stakeholders seek to influence the industry. In some situations indicators have a strong correlation to others in different pillars (particularly transp & perform.). i.e. F.II.2 / F.III.2 (IC-partnerships for local capacity building in research) Following statistical review of Index 2010 indicators, technical sub-committees are removing and refining indicators for Index 2012.

Access to Medicine Index 2010 Results: measuring and comparing 3.How to score performance for the companies for which data is not available? Companies were scored significantly less (where analysts did not have robust data), but initiatives were reflected qualitatively for learning purposes. Scoring of performance and [buisness model] innovations were based on the following: – Inputs – Process – Targets – Outputs – most sought by the Index & stakeholders Index aims to be a driver for better disclosure and reporting of initatives Focus of Innovation indicators

Access to Medicine Index 2010 Results: measuring and comparing 4.How to analyse and compare data provided by the companies that comes in different units and structures? Index is a relative assessment tool, comparability of data is necessary but can present a major challenge, such as: a)Differences in geographical breakdown of revenue. EMEA and RoW (mix developed and developing) are prevalent over World Bank or UN definitions. b)Differences in definition & calculations of ‘price’ / ‘value’. Weak disclosure of – and variability in – ‘cost’ definition. Prices & definition of tiers use ‘relative’ [western] benchmark b)Differences in measurement approach to ‘supply volume’. Key output measure: supply units, vol. active ingredient, Tx-doses, vials of product, or patients reached.

Access to Medicine Index 2010 Results: measuring and comparing 5.How to take into consideration the actual impact of company programs on relieving social burden? Challenges remain which compound reliable measurement: Low and ad hoc disclosure by companies (& other groups) Lack of harmonised measures Multiplicity of factors external to companies Measurement is important for reasons such as: Reliable proof of their impact on health burden acceptable to all stakeholders. That competition between companies on access is on indicators that matter to situation on the ground.

Access to Medicine Index 2010 Conclusions Index hopes to progressively address many of the challenges presented to improve the assessment and comparison: Short-term: Some challenges (such as correlation of indicators) we are taking steps to address ahead of Index Longer-term: Index can be a facilitator of greater – and more meaningful – data disclosure, performance, business model innovation and data harmonisation. BUT will take time & a collective effort. Additionally the Index hopes: To inspire further academic research in the area.... To build a better understanding of how it is motivating change within the pharmaceutical companies …. It’s implications and learnings are diffused accross-s ector (measure social component of other businesses)....

Access to Medicine Index 2010 The Final Ranking…. 15 Management Public PolicyR&DPricingPatentsCapabilityDonations & Philanthropy

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