Pharmaceutical Firms Step Up Access Plans but Healthcare Gaps Persist, Report Finds

A healthcare worker dispenses medicine to a patient at a hospital pharmacy, highlighting the importance of access to affordable and essential healthcare products. 

Pharmaceutical companies are increasingly incorporating access to medicine into their product development strategies, but progress in ensuring essential healthcare products reach patients in low- and middle-income countries remains insufficient, a new global report has found.

The 2026 Access to Medicine Index, released by the Access to Medicine Foundation, shows that access plans now cover 69 per cent of late-stage pharmaceutical pipeline candidates, more than three times the proportion recorded in 2018.

However, the report warns that progress remains uneven across diseases and markets, with affordability, availability and supply challenges continuing to prevent millions of people from accessing essential treatments.

The Index, which marks 20 years of tracking pharmaceutical companies’ efforts to improve global health equity, notes that access to medicine has increasingly become part of corporate business strategies rather than an activity considered only after products are developed.

Access to Medicine Foundation Chief Executive Officer Jayasree K. Iyer said two decades of tracking industry performance had demonstrated the progress made and provided companies with practical approaches to address persistent healthcare inequalities.

“Twenty years of progress have put us in a stronger position than ever to tackle persistent gaps in access. The Index has shown what works, companies have more tools at their disposal and access is increasingly being considered earlier,” she said.

“The opportunity now is to build on that foundation and reach many more people,” Iyer added.

The report identifies cancer treatment as one of the areas requiring greater attention, noting that oncology products account for approximately half of all pharmaceutical clinical development candidates.

Although access plans now cover 65 per cent of oncology pipeline candidates, efforts to reach underserved populations remain limited, particularly in low-income countries.

Strategies to improve access have been identified for 74 per cent of assessed cancer products in lower-middle-income countries, compared with 19 per cent in low-income countries.

Companies including AstraZeneca, Bristol Myers Squibb and Roche have also demonstrated efforts to address broader barriers to cancer treatment, including challenges along the patient care pathway beyond the availability of medicines.

The Foundation recommends stronger collaboration with established cancer programmes and treatment centres in developing countries to improve screening, diagnosis, affordability and healthcare capacity.

On diabetes, the Index identifies 25 research and development projects across six pharmaceutical companies, with innovation largely concentrated on glucagon-like peptide-1 (GLP-1) medicines.

Despite the growing research pipeline, access to newer diabetes treatments remains limited in low- and middle-income countries, while insulin, a long-established treatment, remains unaffordable or inaccessible to many patients.

Pharmaceutical companies Lilly, Novo Nordisk and Sanofi are undertaking initiatives to expand insulin access, although significant gaps persist, particularly in lower-income countries.

The report calls for stronger delivery systems, partnerships and measurable commitments to ensure that advances in diabetes treatment do not deepen existing healthcare inequalities.

It also highlights the expansion of inclusive business models designed to improve access among underserved populations.

Six pharmaceutical companies now operate multi-country inclusive business models, up from five in 2024, collectively covering all 113 low- and middle-income countries assessed by the Index.

Although most companies report an increase in the number of patients reached, the Foundation notes that insufficient product-level reporting makes it difficult to establish the actual impact of the initiatives.

It recommends greater transparency in reporting patient numbers, products supplied and countries reached to establish whether the models are delivering sustainable improvements in access.

Access to Medicine Foundation Director of Research Claudia Martínez said the industry had made progress through new product approvals, licensing agreements, innovations and partnerships, but the initiatives remained concentrated among a limited number of companies and diseases.

“The 2026 Index shows some important shifts in how companies are approaching access. We’re seeing more sustainable models for reaching patients, important product approvals, promising innovations in the pipeline and new licensing agreements,” she said.

“But these efforts are still concentrated among too few companies, products and diseases. The challenge now is to take what works further and faster, and see these approaches adopted much more widely across the industry,” Martínez added.

In the overall company rankings, Novartis retained the top position for the second time, followed by GSK in second place.

Both companies ranked highest in all three technical areas assessed: Governance of Access, Research and Development, and Product Delivery.

AstraZeneca ranked third, followed by Sanofi in fourth, Bayer fifth, Boehringer Ingelheim and Roche tied in sixth place, while Pfizer ranked eighth.

The 2026 assessment introduced changes to its methodology, reducing the number of indicators while placing greater emphasis on implementation and measurable outcomes to distinguish companies demonstrating practical progress.

The report’s analysis covered the period between June 1, 2024 and May 31, 2026, assessing pharmaceutical companies’ efforts to improve access to medicines in 113 low- and middle-income countries.

It calls on pharmaceutical firms and other global health stakeholders to strengthen partnerships, adopt sustainable delivery models and ensure that medical innovation translates into affordable and accessible healthcare for underserved populations.