Access to Medicine Index 2022 ▶ Company report cards

RA N KSCO R E20

1.79

18 (2021)*

Eli Lilly & Co
Stock exchange: NYSE • Ticker: LLY • HQ: Indianapolis, Indiana, United States • Employees: ~35,000

PERFORMANCE IN THE 2022 INDEX
20th place. Eli Lilly is in the lower ranks across all Technical
Areas. The company has a small priority R&D pipeline andhas no structured process for access planning during R&D.
Its Governance of Access policies are comparatively poor,

How score was achieved
3.29

Governance of Access
1.90

Research & Development
1.31

Product Delivery

with no publicly-available evidence found of responsible

0

1

promotional practices and top-level incentivisation to achieveaccess-related goals.

2

3

Average

Leader4

5

framework in place for R&D projects. It has a small-sized priGovernance of Access: 19th place. Eli Lilly performs poorly

ority pipeline compared its peers, with plans for registrationin this area. It has an access-to-medicine strategy centred

for most late-stage pipeline candidates. Eli Lilly does not par-around its Lilly 30x30 programme and publicly discloses out-

ticipate in R&D capacity building.

comes of its access-to-medicine initiatives, but it discloses
little information related to responsible promotional practices

Product Delivery: 20th place. Eli Lilly performs poorly in thisand lacks evidence of access-related incentives for its seniorarea. It does not disclose, neither publicly nor to the Index,

executives and in-country and regional managers as well as

access strategies for its products nor examples of manufac-

some compliance controls to mitigate the risk of non-compli-

turing and supply chain capacity building initiatives. However,ance in countries in scope of the Index.

the Index identified several high-quality health systems
strengthening initiatives in which the company participates.

Research & Development: 16th place. Eli Lilly performs below

The company has a non-exclusive voluntary licensing agree-

average in this area. Eli Lilly does not have an access planningment in place for one compound.

OPPORTUNITIES FOR ELI LILLYCHANGES SINCE THE 2021 INDEX

Review sales incentive structure. Eli Lilly has an access-to-medicine strategy integrated• Extended support in 2021 to the Pioneering Antimicrobial

within its overall corporate strategy and incentivises its CEO to achieve access-tomedicine goals. It can decouple sales incentives for its sales agents from sales volume incountries in scope of the Index.

Subscriptions to End Upsurging Resistance (PASTEUR) Act.
• Disclosed progress in patient reach through the Lilly 30x30
Programme, reaching 11.6 million people in 2021 out of the
30 million 2030 goal.

Develop a structured access planning framework and ensure all late-stage R&D
projects have comprehensive access plans. Eli Lilly has access plans in place for 76% oflate-stage R&D projects. The company can develop a structured access planning process
in order to develop access plans for all late-stage R&D projects. For example, Eli Lilly can
expand access plans for tirzepatide for type 2 diabetes, and new cancer treatments suchas sintilimab, to include further access commitments beyond registration of the productin countries where it is conducting clinical trials.

• Issued a royalty-free, non-exclusive voluntary license forbaricitinib (a drug repurposed to treat COVID-19) to three
Indian drug makers.
• Invested USD 100 million into the newly launched
Antimicrobial Resistance (AMR) Action Fund.
• Expanded the initiative in partnership with Life for a Childto provide free immediate care as well as build sustainablediabetes care models for vulnerable populations. Starting in

Expand registration of medicines. Eli Lilly did not disclose any evidence of new data

February 2021, the partners plan to expand access to careregarding registration filings. The company can expand registration of new products

for youth with diabetes from approximately 23,000 in 2020

such as selpercatinib (Retevmo®/Retsevmo®), indicated for thyroid and lung cancer, andto approximately 150,000 in 65 countries over the next 10

analogue insulins such as insulin lispro (Lyumjev™) and insulin glargine (Basaglar®).

years.
• Committed USD 14.4 million in a new partnership with

Expand access strategies to patented cancer products. Eli Lilly can expand access to

UNICEF to help improve health outcomes for 10 million

its patented cancer products, such as abemaciclib (Verzenio®) for breast cancer, by

children and adolescents living with chronic, non-applying different access strategies, such as equitable pricing. Additionally, it can engage

communicable diseases (NCDs) through 2025.

in non-exclusive voluntary licensing for this product to enable generic supply, as it did forbaricitinib (Olumiant®) for the treatment of COVID-19, in India.

33

All companies were assessed based on
information that was valid in the latest
period of analysis (ending at 31 May2022). This data was either submitted bycompanies, found in the public domain or
was accessible through other sources. For

the 2022 Index, Eli Lilly declined to submit
data to the Access to Medicine Index.
The term LMICs is used to denote all
low- and middle-income countries inscope of the Index, except when analysing
companies’ access strategies where

the use of LMIC refers to lower-middle
income countries as per the World Bank
income groups classification. Likewise, theterms LIC and UMIC refer to low income
countries and upper-middle income
countries.

*In the 2021 Index, dense ranking wasused. In the 2022 Index, standard
competitive ranking is used. Therefore, adirect comparison with Eli Lilly's previous
rank is not possible.

Access to Medicine Index 2022 ▶ Company report cards

SALES AND OPERATIONSBusiness segments: Human pharmaceutical

Eli Lilly’s products are sold in 72* out of

products.

108 countries in scope of the Index. Eli Lilly

Therapeutic areas: Diabetes, immunology,

has sales offices in 14 countries and sells via

Human pharmaceutical products

neuroscience, oncology and other therapies.

suppliers and/or pooled procurement in 68*

		Product categories: Innovative medicines.

countries.

Total

M&A news: Eli Lilly acquired Prevail

Revenue by segment (2021) – in USD
28.32 bn
28.32 bn

*In 2016, Eli Lilly reported sales in 72 countries.

Therapeutics Inc. in January 2021 for USD
747.4 million. Eli Lilly also acquired Protomer
Technologies in July 2021 for USD 1 billion.

Sales by geographic region
50

Revenue (Bn USD)

Sales in countries in scope

40
30
20
10
0

2017

In scope, has sales offices

2018

2019

Other foreign countries

In scope, sales unknownUSA

Not in scope

2020
Europe

2021
Japan

China

SAMPLE OF PIPELINE AND PORTFOLIO ASSESSED BY THE INDEXPIPELINE for diseases in scope

PORTFOLIO as selected for analysis by the Index

Eli Lilly has a total of 45 R&D projects in scope with three of these pro-Eli Lilly has 26 medicines in scope, 18 of which are on patent. 19% of thesejects targeting priority diseases. The other 42 R&D projects target othermedicines are on the WHO EML (5). The off-patent medicines target

diseases in scope. Of the projects targeting priority diseases, the focus is

non-communicable diseases (NCDs) such as diabetes (5), cancer (1) andon COVID-19 (three projects). Of the projects targeting other diseases, theunipolar depressive disorders (1). The on-patent medicines target NCDs

focus is on diabetes mellitus (13), oncology (12) and ischaemic heart dis-such as diabetes (9), cancer (4) cardiovascular disease (1) and migraine (2).

ease (7).
Seventeen R&D projects are in late-stage development that target either apriority disease (3) or address a public health need in LMICs (14).* Evidenceof access planning was in place for 76% of these projects: three targeting apriority disease and ten addressing a public health need in LMICs.
45 projects in the pipeline

26 products as selected for analysis by the Index†

3

Maternal and neonatal 0

Maternal and neonatal 042

Non-communicableMultiple categories 0
0

20
30
40
50
projects in the pipeline

10

20
30
40
50
products on the market

Breakdown of products

0

0

0

0

3

0

3

Contraceptives

Addresses needs of LMICs*

5

4

7

3

0 19

Diagnostics

Other projects in scope

15

3

3

2

0 23

Other

*50 diseases and 243 product gaps inscope have been established as a priority by global health stakeholders. For
other diseases, the Index used a set of criteria to determine which projects in thepipeline offer a clear public health benefit to patients in LMICs. Only projects inthe clinical phase of development were
included for this analysis.
**Neglected tropical diseases, while also
communicable, are highlighted separately
throughout the Index.
***Other includes projects that have atechnical lifecycle and projects that fol-

‡

Total

0

Targets established R&D priorities

Other

0

Vaccines

WHO EDL

0

Total

0

Other***

0Registration/approval

80Phase III

4

Phase II

17

4

Phase I1

off patent

Pre-clinical

Medicines on patent

Discovery

Non-EML

10

Breakdown of projects

3424

Non-communicableMultiple categories 002Communicable**

Neglected tropical 0

WHO EML

Communicable**
Neglected tropical 0

18

0
0

0
0

low a different development cycle (e.g.
diagnostics).
†Products included in the analysis wereselected using a set of criteria determinedby stakeholder consensus.
‡Other includes vector control products.

0

Access to Medicine Index 2022 ▶ Company report cards

Eli Lilly & Co

GOVERNANCE OF ACCESSRANK 19SCORE 3.29

Has an access-to-medicine strategy with

It publicly discloses its commitments, objec-

Index: a continuous system to monitor activities,

measurable objectives, integrated with its cor-

tives and targets related to improving access toaudits, formal processes to ensure third-party

porate strategy. Eli Lilly performs well. It has an

medicine in countries in scope of the Index. It

compliance with company standards and country

access-to-medicine strategy, which covers somefacilitates accountability and transparency by con-risk-based assessments in every country or regionof the therapeutic areas in which the company

sistently sharing the outcomes of its Lilly 30x30

where there is an Ethics & Compliance officer

is involved. The strategy is centred around theProgramme in a centralised manner within its

present. There is no evidence, publicly found or

Lilly 30x30 programme, which focuses on dis-

ESG report.

disclosed to the Index, of a fraud-specific riskeases that disproportionately affect people inassessment. No breaches in countries in scope

resource-limited settings. The highest responsi-

Performs comparatively poorly in responsibleof the Index were publicly found in the period ofbility lies indirectly with the board, with a seniorpromotional practices. Eli Lilly does not dis-analysis.

executive responsible for access strategies andclose whether sales agents are incentivised onreporting to the Executive Committee, which ismeasures other than sales volume. There is evi-

Does not publicly support the Doha Declaration

chaired by the CEO.

dence that the company sets incentives basedon TRIPS and Public Health. Eli Lilly doeson sales targets at the individual level for agents.

not publicly share any support of the Doha

Provides evidence of financial access-re-

It does not publicly disclose information related

Declaration on TRIPS and Public Health, but dis-lated incentives at the executive level. Eli Lilly

to transfers of values to healthcare professionals

closed to the Index that its position aligns withperforms well. The CEO has access-related

in countries in scope of the Index (e.g. payments

IFPMA. There is evidence of industry association

incentives linked to its ability to drive the 30x30

for attending events or promotional activities),

lobbying on intellectual property and the usage ofstrategy and ensure progress. Eli Lilly does notunless required by local regulations or trade

TRIPS flexibilities, namely of compulsory licens-disclose, however, whether senior executives andassociations.

ing, by national governments in some countries inin-country managers are also incentivised toward

scope of the Index. As a member of the industry
Has compliance controls to ensure that gov-

association, Eli Lilly, like all other member compa-

ernance efforts are not undermined bynies in scope of the Index, is by default connected

Publicly disclose outcomes of its

non-compliant or corrupt activities. Eli Lillyto this activity.

access-to-medicine activities. Eli Lilly performs

has an average performance, demonstrating evi-strongly in transparency of access activities.

dence of some components looked for by theaccess goals.

RESEARCH & DEVELOPMENTRANK 16SCORE 1.90

No structured process for access planning

pricing for its bebtelovimab, a monoclonal anti-

policy whereby once a product is approved, it

reported. Eli Lilly does not report a structured

body therapeutic for COVID-19. Through the Bill

commits to registering it in all countries where

process to develop access plans during R&D. The& Melinda Gates Foundation, Eli Lilly provided

clinical trials have taken place. Therefore, planscompany did not report a structured timeline

doses of bamlanivimab free of charge in Rwanda

for registration in countries where clinical trials

for the development of access plans for its R&D

and Morocco.

are being carried out apply to 10 of the 14 late-projects.

stage projects.
Many projects address a public health need in

35

A small-sized priority R&D pipeline compared

LMICs,* with 71% (10/14) of late-stage candi-

Does not publicly disclose R&D investment

to peers, with access plans in place for 100%

dates covered by access plans. In this analysis,

data disaggregated by disease category, prod-(3/3) late-stage candidates. Eli Lilly has three

Eli Lilly has 14 late-stage R&D projects that

uct type or phase of development. Eli Lilly does

late-stage candidates in its pipeline that target atarget a disease and/or product gap not yet

not disclose disaggregated R&D investment datapriority product gap. These focus on COVID-19.

established as a priority by global health stake-to global health organisations.

The company did not disclose any access plans

holders. These projects are all deemed by thefor these late-stage projects. However, evidence

Index to offer a clear public health benefit for

No R&D capacity building initiatives includedof access plans for all three COVID-19 projects

people living in LMICs.* Primarily, these pro-for evaluation. There is no evidence — in thewas found in the public domain. For example, Eli

jects concern clinical trials in countries in scope

public domain or disclosed to the Index — of

Lilly has issued royalty-free, non-exclusive vol-of the Index and/or are first-in-class molecules.

R&D capacity building initiatives active during theuntary licenses to accelerate and expand theThese projects focus on several diseases includ-

period of analysis that met inclusion criteria foravailability of baricitinib (Olumiant®) to treat

ing Alzheimer's disease, diabetes mellitus (type 1

evaluation. Eli Lilly's performance is below aver-

COVID-19 in India. This plan also considers dona-and 2), cancer and cardiovascular diseases. The

age in this area.

tions and registration in countries in scope. Elicompany did not disclose any access plans for

Lilly considers supply, demand, and equitable

the late-stage projects. However, Eli Lilly has a*50 diseases and 243 product gaps inscope have been established as a priority
by global health stakeholders. For otherdiseases, the Index used a set of criteria
to determine which projects in the pipeline offer a clear public health benefit topatients in LMICs. Projects in the clinicalphase of development were included forthis analysis.

Access to Medicine Index 2022 ▶ Company report cards

PRODUCT DELIVERYRANK 20SCORE 1.31

Public commitment not to enforce patents inbaricitinib tablets to the Indian government for

any inclusive business models that aim to meetcountries in scope. Eli Lilly publicly pledges toeligible hospitalised COVID-19 patients in India.

the access needs of populations at the base ofneither file for nor enforce patents. This com-

On May 4 2021, Eli Lilly announced it would

the income pyramid (including other underserved

mitment, available online in the "2018 UNGC

donate doses of barcitinib and bamlanivimab/

populations) in LMICs. Eli Lilly performs below

Communication on Progress" report, applies to all

etesevimab to Direct Relief. This donation would

average in this area.

Least Developed Countries.

enable the humanitarian organisation to provide
COVID-19 therapies at no cost to LMICs mostShows average performance in terms of ensur-

Publicly discloses information on patent status.

heavily impacted by the pandemic. The number

ing continuous supply of medicines in LMICs. Eli

Like most of its peers, Eli Lilly publicly discloses

of doses donated was not disclosed.

Lilly has a system in place to work with relevant

the patent statuses for small molecules in scope

stakeholders to communicate issues that may

via the Pat-INFORMED database. Eli Lilly includes

No evidence of access strategies for any of its

affect the supply chain, manages a buffer stock of

information about patents, including filing date,self-administered products in scope for thisrelevant products, and produces in-house active

grant number, grant date and jurisdiction.

analysis. Eli Lilly has not disclosed, neither pub-pharmaceutical ingredients to prevent shortages.

licly nor to the Index, access strategies for any ofHowever, there is no evidence that the company

Performs below average in terms of sharing

the five products, assessed in this category. Fouris involved in technology transfers to manufac-

intellectual property (IP) assets with third-

products in this category are indicated for dia-turers in LMICs or supply chain capacity building

party researchers. Eli Lilly engaged in one newbetes mellitus treatment and one product is ainitiatives that meet the inclusion criteria for

IP-sharing agreement with third-party research

cancer treatment.

evaluation.

lished during the current analysis period that

No manufacturing capacity building initiatives

Has a policy for reporting substandard and fal-meets all inclusion criteria for evaluation. The

included for analysis. There is no evidence — insified (SF) medicines in countries in scope ofcompany does not have existing agreements ofthe public domain or disclosed to the Index — ofthe Index. Eli Lilly provides evidence of a policy

this nature in place that were established before

manufacturing capacity building initiatives active

for reporting SF medicines to relevant national

the current period of analysis and meet all inclu-

during the period of analysis that met inclusion

health authorities. However, it does not disclose,

sion criteria for evaluation.

criteria for evaluation. Eli Lilly's performance ispublicly or to the Index, evidence that it requires

below average in this area.

reporting to occur within the timeframe of ten

institutions or drug discovery initiatives estab-

Uses licensing agreements to enable genericdays looked for by the Index. Eli Lilly also does not

supply. Eli Lilly has a non-exclusive voluntary

No supply chain capacity building initiatives

provide evidence of shortened time frames forlicensing agreement in place for one compound,included for analysis. There is no evidence — inreporting cases which only require visual inspec-

baricitinib (Olumiant®) in India. Details of thisthe public domain or disclosed to the Index — oftion to be confirmed.

agreement are not publicly available.

supply chain capacity building initiatives active
during the period of analysis that met inclusion

Donates in response to expressed need andNo evidence of filing for registration new prod-

criteria for evaluation. Eli Lilly's performance ismonitors delivery. Eli Lilly has public policies

ucts in any country in scope on average. Eli Lilly

below average in this area.

and supply processes in place to ensure ad hoc

did not disclose evidence of filing for registration
any of its analysed products.

donations are carried out rapidly in response to
Two of the four health systems strengthen-expressed need, and it monitors the delivery of

ing initiatives included meet all Good Practice

donations until they reach the patient.

Eli Lilly is not eligible for assessment of supra-

Standards. Eli Lilly's performance is average innationally procured products.

this area. The number of initiatives meeting all

Has no long-term donation programmes forinclusion criteria is average but fewer initiatives

neglected tropical diseases or malaria thatHas access strategies for one of its healthcare

meet all Good Practice Standards (GPS) thanare eligible for analysis under this indicator.

practitioner-administered products in scope ofwhat is average for this indicator. For example,

However, the company is engaged in other struc-

this analysis. Eli Lilly performs below average in

Eli Lilly is a partner in the Africa Health Worker

tured donation programmes, such as the Life forthis area. For one of five products assessed in thisTraining Initiative with Living Goods and Last Milea Child programme where it donates insulin lis-

category, examples of access strategies in LMIC

Health which explores novel approaches to train-pro (Humalog®), an analogue insulin used to treat

were found publicly. For example, the company

ing and retaining community health workers. This

type 1 diabetes mellitus, in 23 countries since

has issued royalty-free, non-exclusive voluntary

initiative meets all GPS.

2009.

licences to three Indian drug makers, Cipla, Sun

36

Pharmaceuticals and Lupin, to manufacture andHas no inclusive business models that meet all

distribute baricitinib (Olumiant®) to treat COVID-

inclusion criteria. There is no evidence that Eli

19. In addition, Eli Lilly has donated 400,000

Lilly has engaged in the piloting or scale-up of