AMR Benchmark Opportunities: progress update

Research-based pharmaceutical company

Pfizer Inc
This table is part of a November 2023 report that looks at what actions each company in scope of the Antimicrobial
Resistance (AMR) Benchmark has taken with regards to each of the Opportunities set out in its 2021 AMR Benchmark
Report Card. The full 2021 Report Card is also included in this PDF.

2021 O PPO RTU N IT Y

2023 U PDATE

What was the Opportunity shared in the AMR Benchmark?

What progress has been made on this Opportunity?

Fully decouple incentives for sales agents from sales

Pfizer plans to continue its practice of decoupling incentives

volumes.

for sales agents from sales volume in the countries where

Pfizer fully decouples incentives for sales agents from sales

newer access and reimbursement models are implemented,

volumes of antibacterial medicines in the UK. It can expand

such as the ‘subscription model’ used in the United Kingdom.

this practice to all countries it operates in and to all antibac-

In countries where it doesn’t decouple incentives forterial and antifungal medicines.

sales agents from sales volume, the company implemented
a partial decoupling of financial incentives from sales
volumes. In Brazil, sales agents were completely replacedby company representatives whose role and financial incentives are fully decoupled from sales volumes.

Expand breadth of R&D pipeline into more pathogens.

Pfizer entered into a licensing agreement that encom-

Pfizer has the largest late-stage clinical pipeline comparedpasses commercial rights globally, with the exception ofto peers in the AMR Benchmark. It has made a series ofAsia and the United States, for SPR206, an investigational

acquisitions of small biotech companies to increase the size

IV-administered polymyxin product candidate targetingof its pipeline. Pfizer can expand the focus of its pipeline to

MDR gram-negative bacterial infections in hospital settings.

target resistant pathogens for which R&D is limited, such as
Campylobacter spp. and H. pylori.

Meanwhile, the company has completed the Phase I trial
for its oral antibacterial combination ceftibuten-avibactam
prodrug, a potential treatment option for infections caused
by MDR Enterobacterales. Pfizer is considering opportunities to continue the development of its Clostridioides
difficile vaccine (PF-06425090), following non-attainmentof its pre-specified primary endpoint of preventing primary
C. difficile infection (CDI). Additionally, Pfizer’s maternal
vaccine candidate for prevention of Group B Streptococcus
infection in infants is set to enter Phase III in the latter
half of 2023. In September 2022, the Bill & Melinda Gates
Foundation announced a USD 100 million grant to help
support this candidate’s development into Phase III, and if
successfully developed and licensed, its future accessibility
in lower-income countries.
Pfizer’s pipeline also previously included fosmanogepix,
an antifungal, which completed Phase II of development. In
November 2023, Basilea Pharmaceutica announced it had
acquired this treatment candidate.

Ensure compliance with antibacterial discharge limits

Pfizer reports that over 100 antibiotic supplier sites

at suppliers’ sites by tracking and publicly disclosing(approximately 86%) have met voluntary discharge limits inprogress and results specific to antibacterials for all sites.

the receiving environment. The company is committed to

Pfizer tracks the compliance of all own sites with set dis-working with its antibiotic suppliers to achieve discharge

charge limits. It can also track such compliance of all its sup-limits by the end of 2025. Additionally, Pfizer reports it ispliers’ sites since Pfizer reports all suppliers have quantified

actively working with the remaining approximately 14% of

discharge levels and it can publicly disclose the results. The

suppliers to support them in meeting discharge limits.

company currently publishes information on compliance

Similar to 2021, Pfizer does not publicly disclose auditof own and suppliers’ sites with the guidelines of the AMR

results containing antibacterial discharge levels for both its

Industry Alliance but it is unclear whether this includes com-

own sites and suppliers’ sites. Furthermore, the company

pliance to discharge limits.

does not disclose the names and locations of its suppliers.
20

AMR Benchmark Opportunities: progress update

Research-based pharmaceutical company

2021 O PPO RTU N IT Y

2023 U PDATE

What was the Opportunity shared in the AMR Benchmark?

What progress has been made on this Opportunity?

Expand registration of Trumenba and NeisVac-C.

Pfizer reports that Trumenba received regulatory approval

Pfizer can file its vaccines Trumenba and NeisVac-C for reg-in one additional low- and middle-income country (LMIC).

istration in more countries, including low-income countries

Although no progress is reported for NeisVac-C, the com-with a high burden of disease.

pany reports it has filed Nimenrix, its other meningococcal
vaccine, for registration in eight LMICs since 2021.
Additionally, Cresemba, an antifungal, has been registeredin eight additional LMICs. Zavicefta, a Reserve antibiotic
listed on the 2023 World Health Organization (WHO) Model
List of Essential Medicines (EML), has been registered in six
additional LMICs and filed for registration in one additional
LMIC.

Expand accessibility of its antibacterial and antifungal

Pfizer reports that, as of May 2023, approximately 71,000

medicines in access countries.

patients in LMICs have been treated with Cresemba,

Pfizer can implement new programmes and partnerships to

Zavicefta or Zinforo – already exceeding the total number

expand access to its antibacterial and antifungal medicines

treated with these medicines throughout the entirety ofin access countries while demonstrating how it improves2020 by 20,000, as reported in 2021.

the availability and affordability of its medicines, including in

In 2023, Pfizer expanded its commitment to its Accord

low-income countries. For example, it can expand access tofor a Healthier World initiative. This expansion provides

Zavicefta® and Zinforo® in Sub-Saharan Africa while taking

individuals in 45 LMICs, 43 of which are in scope of theability-to-pay into account.

Benchmark, with access to Pfizer’s full portfolio of on-patent and off-patent medicines and vaccines for which it
has global rights, including 11 branded antibiotics and fourbranded antifungals, on a not-for-profit basis. Rwanda was
the first country to receive deliveries of these branded products through the Accord, which included nine medicines andvaccines, including Zavicefta and Nimenrix. Pfizer reports it
is currently expecting product orders, which include antibiotics and antifungals, from countries outside of Rwanda andexpects to ship them in the latter half of 2023.
In Ghana, Pfizer partnered with a local health-techcompany to provide price discounts and microfinancing topatients, thereby improving the affordability of Zavicefta.
Additionally, Pfizer was awarded a contract by UNICEF to
supply 500,000 doses of Nimenrix for UNICEF’s 2022 and2023 emergency stockpile programme.

21

Antimicrobial Resistance Benchmark 2021

PFZ

Overall Performance
2020

2021

69 % 81% ▲Access to Medicine Foundation

Pfizer Inc
Large R&D-based pharmaceutical company
Stock exchange: NYSE • Ticker: PFE • HQ: New York, NY, United States • Employees:
78,500PERFORMANCE
Pfizer performs well overall in its evaluated Research Areas compared to

PFZ
Performance in the Benchmark0%

the other large research-based pharmaceutical companies in scope.
R&D: Pfizer performs strongly in R&D. Its 13-project pipeline includes
five vaccines. Seven of its projects target critical and/or urgent
pathogens. It has a novel antifungal in clinical development. Pfizer
reports access and stewardship plans for all eight of its late-stage
projects.
Responsible Manufacturing: Performs strongly. Reports comprehensive

Appropriate Access: Performs strongly. Files some of its on-off-patent

Stewardship: Is the leader. It publicly shares raw data of its ATLAS
surveillance programme. It fully decouples incentives for sales agentsfrom antibacterial sales volumes in the UK. It reports comprehensive
conflict of interest mitigation for its educational programmes. It adapts
packaging for patients.

100%

PointsR&D

77%

23/ 30

Manufacturing

80%

12/ 15

Access80%

28/ 3590%

Stewardship
0%50%

18/ 20100%

How Pfizer was evaluatedproducts for registration in access countries. Reports several strategies
to expand access and ensure continuous supply of its relevant products.

50%

81/ 100

Performance by Research Area

environmental risk-management strategy for own sites and suppliers;
quantifies discharge levels at all its own and supplier sites.

Points81%

Overall score

A R&D

1

2.1 2.2 2.3 2.4

3

●

●

●

●

1

2

3

B Manufacturing ●

●

●

●

●

1.1

1.2 1.3 2.1 2.2 2.3

3

C Access

●

●

●

4

5

6

7

C Stewardship

●

●

●

●

●

●

●

●

● ● ● Scored●

Not scored

OPPORTUNITIES FOR PFIZERCHANGES SINCE 2020

Fully decouple incentives for sales agents from sales volumes. Pfizer fully decouples incentives for• In February 2021, BSAC, the European Bank

sales agents from sales volumes of antibacterial medicines in the UK. It can expand this practice tofor Reconstruction and Development, EBRD,

all countries it operates in and to all antibacterial and antifungal medicines.

and Pfizer co-created a global digital learning

Expand breadth of R&D pipeline into more pathogens. Pfizer has the largest late-stage clinicalnetwork for HCPs addressing AMR, antimicro-

pipeline compared to peers in the AMR Benchmark. It has made a series of acquisitions of small bio-

bial stewardship (AMS), and COVID’s impact

tech companies to increase the size of its pipeline. Pfizer can expand the focus of its pipeline totarget resistant pathogens for which R&D is limited, such as Campylobacter spp. and H. pylori.

on AMR and pandemic planning.
• Pfizer is addressing antimicrobial steward-

Ensure compliance with antibacterial discharge limits at suppliers’ sites by tracking and pub-ship health disparities through multiple efforts.

licly disclosing progress and results specific to antibacterials for all sites. Pfizer tracks the com-

As part of its efforts, Pfizer and the Wellcome

pliance of all own sites with set discharge limits. It can also track such compliance of all its suppli-

Trust launched the Surveillance Partnershipers’ sites since Pfizer reports all suppliers have quantified discharge levels and it can publicly dis-to Improve Data for Action on Antimicrobial

close the results. The company currently publishes information on compliance of own and suppliers’

Resistance (SPIDAAR) in July 2020, whichsites with the guidelines of the AMR Industry Alliance but it is unclear whether this includes compli-

is a new collaboration with the governments

ance to discharge limits.

of Ghana, Kenya, Malawi and Uganda to track

Expand registration of Trumenba® and NeisVac-C®. Pfizer can file its vaccines Trumenba® andresistance patterns and better understand the

NeisVac-C® for registration in more countries, including low-income countries with a high burden of
disease.

burden of AMR in LMICs.
• Pfizer purchased shares of ContraFect’s

Expand accessibility of its antibacterial and antifungal medicines in access countries. Pfizer cancommon stock for approximately USD 3 mn.

implement new programs and partnerships to expand access to its antibacterial and antifungal

ContraFect intends to use the capital to fundmedicines in access countries while demonstrating how it improves the availability and affordability

its R&D activities, including a Phase III candi-

of its medicines, including in low-income countries. For example, it can expand access to Zavicefta®
and Zinforo® in Sub-Saharan Africa while taking ability-to-pay into account.

date targeting S. aureus.
• In the last year, Pfizer acquired Arixa
Pharmaceuticals and Amplyx Pharmaceuticals,Inc., two companies focused on developing antibacterial and antifungal treatments,
respectively.

22

Antimicrobial Resistance Benchmark 2021

Access to Medicine Foundation

SALES AND OPERATIONSPFZRevenue by business segment

Therapeutic areas: Hospital, Inflammation & immunology, Internal medi-

2019

cine, Oncology, Rare diseases, Vaccines

2020

Business segments: Biopharmaceutical products

39,09041,9080

Product categories: Biosimilars, Generic medicines, Innovative medicines,

10,00020,000Biopharmaceutical Products

Vaccines

2,082

30,00040,000Consumer Health

50,000mn USD

PFZ
Revenue by region

M&A since 2020: In July 2019, Pfizer and GSK combined their consumer
health care business into a joint venture, with Pfizer controlling an equity
interest of 32%. In November 2020, Pfizer spun its Upjohn Business2019

off to combine it with Mylan N.V. to form Viatris Inc. In October 2020,

2020

Pfizer acquired Arixa Pharmaceuticals, a company focused on develop-

20,5930

ing next-generation oral antibiotics for drug-resistant Gram-negative infec-

20,57921,712
10,000

United States

20,19620,00030,00040,000International

50,000mn USDtions. In April 2021, Pfizer acquired Amplyx Pharmaceuticals, Inc., including their lead drug fosmanogepix, a potentially first-in-class antifungal
treatment.
PIPELINE for pathogens in scope

PORTFOLIO for pathogens in scope

Pipeline size: 13 projects targeting pathogens in scope* (7 antibacterial

Comparatively large portfolio: At least 116 products: 98 antibacterial medi-

medicines; 5 antibacterial vaccines; 1 antifungal medicine).

cines; 4 antibacterial vaccines; 14 antifungal medicines

Development stages: 6 clinical projects, including a Phase III vaccine can-On-patent medicines: 5 (anidulafungin, ceftazidime/avibactam, ceftaroline,

didate for C. difficile infections and a Phase II clinical vaccine candidate forisavuconazole, tavaborole)

the prevention of group B Streptococcus infections; and 5 discovery/pre-On-patent vaccines: 4 (Trumenba®, NeisVac-C®, Nimenrix®, Prevnar 13®)clinical projects.

Off-patent/generic medicines: 10 of 107 were selected for analysis*

Novelty: 1 project, potential first-in-class Phase II antifungal: fosmanogepix.

(amoxicillin [A], azithromycin [W], chloramphenicol [A], ethambutol/isoni-‘Critical’ and/or ‘urgent’ pathogens: 7 projects, with the focus on resist-azid/pyrazinamide/rifampicin [T], ethambutol/isoniazid/rifampicin [T], flu-

ant Enterobacteriaceae, C. auris and C. difficile. Pfizer has a Phase III vac-conazole [F], minocycline [W], polymyxin b [R], tigecycline [R], voricona-cine candidate for C. difficile. Its Phase II antifungal fosmanogepix targets

zole [F])C. auris.

AWaRe medicines***: 26 Access group; 31 Watch group; 8 Reserve group

Regulatory approvals: 4 approvals. In September 2019, the FDA gave a

Anti-TB medicines***: 11

supplemental approval for ceftaroline fosamil (Teflaro®/Zinforo®)** toPFZPipeline for priority pathogens

treat Acute Bacterial Skin and Skin Structure Infections (ABSSSI) in neonatal populations (from birth to less than 2 months of age). In June 2021, the
FDA approved Prevnar20™, a pneumococcal 20-valent conjugate vaccine
for adults. Avycaz®/Zavicefta®** received two label extensions by the EMA
in October 2020.

0

5

71

0

10

20

PFZ
Products on the market
98 14

PERFORMANCE BY RESEARCH AREA

0

20

40

60

80

100

A

RESEARCH & DEVELOPMENT Evaluated: medicine & vaccine pipelines for priority* bacteria & fungi

A.1

Investments in R&D

icines and/or vaccines for pathogens in scope.

Pfizer does not disclose publicly, or to the

Pfizer has pledged USD 100 mn to the AMR

Benchmark, its R&D investments during 2019

Action Fund over the next ten years.

and 2020 in antibacterial and antifungal med-120

● Antibacterial vaccine● Antibacterial medicine● Antifungal vaccine● Antifungal medicine● Antibacterial vaccine● Antibacterial medicine● Antifungal medicine

A.2.1 Pfizer nearly doubles the size of its
pipeline
The company reports 13 projects targeting pathogens in scope: eight medicines and five vac-

Pipeline targeting priority pathogens: 13† As at 24 September 2021
Discovery

Pre-clinical

Phase I

Phase II

Phase III

Approval

Ceftazidime/avibactam(Avycaz®/Zavicefta®)**[Enterobacteriaceae, P.
aeruginosa] - additional
population: neonates♦ C. difficile vaccine (PF06425090)♦ S. pneumoniae
20-valent conjugate vac-

♦ Group B Streptococcus
vaccine (PF-06760805)
Fosmanogepix [C. auris]

Aztreonam/avibactam(PF-06947387) [Enterobacteriaceae]♦ S. pneumoniae
20-valent conjugate vaccine (Prevnar20™) additional population:
paediatriccine (Prevnar20™)[FDA/Jun-21]‡
Ceftaroline fosamil(Teflaro®/Zinforo®)**[S. aureus][FDA/Sep-19] additional
population: neonates♦ = Vaccine† Includes 5 confidential projects not shown in the figure.
‡ Approved after the end of the period of analysis.

* See Appendix V for information about
eligibility for R&D projects and Appendix
VII for eligibility criteria of products.
** Avycaz® and Teflaro® are marketed byAllergan in the USA.

*** Listed on the 2019 WHO EML.

23

Antimicrobial Resistance Benchmark 2021

Access to Medicine Foundationcines. Twelve targeting bacterial pathogens anddevelopment include candidates targeting C. dif-four of them are vaccines. Three are in Phase II,

one targets fungal pathogens. Out of the 13 pro-ficile, group B Streptococcus and S. pneumoniae.

three in Phase III and two have obtained market-

jects, five are in discovery/preclinical stage, six

In June 2021 Prevnar20™, a 20-valent pneumo-

ing approval.

are in clinical development and two received

coccal vaccine was approved by the FDA. Pfizer

For seven out of eight of its projects in late-marketing approval.

is conducting Phase III trials to extend the use

stage development, Pfizer has ongoing clini-of this newly approved vaccine to paediatriccal trials or aims to file the successful products

populations.

in access countries§. The plans for this projects

A.2.2 Both innovative and adaptive medicine
clinical candidates
Pfizer’s clinical-stage medicine pipeline con-include a wide range of access components such
A.2.4 Seven candidates targeting critical and/or urgent priorities

sists of both innovative and adaptive R&D pro-as filing for registration in access countries§,
equitable pricing and measures to strengthen

jects. Pfizer is working on extending the indi-

Pfizer has seven projects targeting pathogens

supply. Furthermore, its late-stage R&D med-

cations of ceftazidime/avibactam (Avycaz®/defined as ‘critical’ by WHO’s list of priority path-

icine projects are covered by portfolio-wide

Zavicefta®)** and ceftaroline fosamil (Teflaro®/

ogens and/or characterised as ‘urgent’ threats

stewardship plans, including initiatives for sur-

Zinforo®).** It is developing the combination ofby the US Centers for Disease Control andveillance (ATLAS) and research and education

aztreonam/avibactam (PF-06947387) against

Prevention (CDC). In clinical development, Pfizer

on AMR (via unrestricted grants). For its recently

MDR gram-negative infections. In April 2021,

has medicine candidates against Carbapenem-

acquired Phase II antifungal, fosmanogepix,

Pfizer acquired Amplyx Pharmaceuticals Inc andresistant/ESBL-producing E. coli and C. auris,

Pfizer plans to continue the Expanded Accessis now taking over the clinical development of its

and a vaccine candidate targeting C. difficile.

Programme that Amplyx Pharmaceuticals Inc

novel antifungal, fosmanogepix.

had in place.
A.3

A.2.3 Five vaccine candidates

Comprehensive planning for access andstewardship

Pfizer reports five vaccine projects in its pipeline.

Pfizer has eight late-stage R&D projects tar-

It includes three innovative and two adaptive

geting pathogens in scope, the highest number

projects. Pfizer’s vaccines in clinical stages ofacross all the R&D-based companies evaluated,B

RESPONSIBLE MANUFACTURING Evaluated: antibacterials manufacturing (APIs and drug products)

B.1

Comprehensive environmental risk-man-tocols for preventing contamination. It also

agement for own sites and suppliers;

employs conservative measures for effluents

tracks compliance with limits at own

sent to external private and public wastewatersites

treatment plants.

from its own or suppliers’ sites.
B.3

System in place to maintain production
quality for own and suppliers’ sites; norequests for official corrective action

Pfizer reports a comprehensive strategy to minPublicly discloses some information on

Pfizer reports that its own sites and suppliers

and solid waste from antibacterial manufactur-

environmental risk management andhave a system to maintain high-quality antibac-

ing at its sites, including audits every three years.

commitment to set limits

terial production consistent with international

imise the environmental impact of wastewaters

B.2

It reports setting discharge limits in the receiv-

Pfizer publishes some components of its envi-

GMP standards. This includes periodic risk-

ing environment for all antibacterials manufac-

ronmental risk-management strategy. It is abased audits and tracking of corrective and pre-tured at its sites, based on PNECs to limit AMR,

member of the AMR Industry Alliance, which

ventive actions. Pfizer also requires its suppli-

as recommended by the AMR Industry Alliance.

publishes a list of recommended antibacterial

ers to audit their own suppliers. The Benchmark

Discharge levels are quantified at all sites using

discharge targets. Pfizer publishes its commit-

found no requests for official corrective actiona mass balance approach, verified by chemicalment to setting these targets. It also publicly

from the FDA or EMA related to non-conformi-

analysis if applicable. It reports that compliancediscloses that it is developing a, AMR Industry

ties with cGMP at Pfizer’s own sites or any sub-of own sites with discharge limits is tracked.

Alliance sponsored, consensus-based standard

sidiaries that manufacture antibacterials.

Pfizer requires third-party suppliers of anti-

to demonstrate responsible manufacturing ofbacterials to follow the same standards, includ-

antibiotics. Pfizer publicly discloses that >90%

ing limits based on PNECs. It reports conduct-of own sites are compliant with the guidelines ofing on-site audits at least every five years. It

the AMR Industry Alliance, and that >80% sup-requests and reviews the discharge levels of its

pliers are assessed against these guidelines. It is

suppliers. All supplier sites have quantified dis-

unclear whether such compliance also includes

charge levels.

compliance with discharge limits. Pfizer does not

Pfizer expects external private waste-treat-publish: (1) the results of environmental audits,ment plants to comply with its general environ-conducted at its own sites, the sites of suppliers

mental standards. It audits these plants every

and/or external private and public waste-treat-

3-6 years which includes the suitability of tech-ment plants; (2) a list of these suppliers andnologies used for processing waste and pro-plants; or (3) the levels of antibacterial discharge

C

APPROPRIATE ACCESS & STEWARDSHIP – ACCESS

Evaluated: access activities relating to antibacterial & antifungal medicines & vaccines in 102 access countries§
C.1.1

Filed to register on-patent medicines ingal anidulafungin (Eraxis; Ecalta®) used to treat

14 access countries on averageinvasive candidiasis, filed in 22 access coun-registration in nine access countries.
C.1.2 Filed to register off-patent/generic med-

Pfizer performs above average, filing four oftries. Its reserve antibiotic, ceftazidime/avibac-

its five relevant on-patent medicines for regis-tam (Zavicefta®), was filed for registration in 20

tration in 14 access countries§ on average. Its

access countries, including three LICs. Its anti-

Pfizer performs above average, filing eight of ten

most widely filed relevant product is the antifun-

fungal isavuconazole (Cresemba®) was filed forrelevant off-patent/generic medicines for reg-** Avycaz® and Teflaro® are marketed byAllergan in the USA.
§ 102 low- and middle-income countries
where better access to medicine is mostneeded.

icines in 17 access countries on average

24Antimicrobial Resistance Benchmark 2021

Access to Medicine Foundation

istration in 17 access countries on average. Itsfor all its reported approaches. It estimates to

It has set a six-tiered pricing policy for Prevnar

most widely filed relevant product is the antifun-

have ensured access to ceftaroline (Zinforo®)13®. The tiers are defined by several criteria

gal fluconazole, filed in 52 access countries. Six

ceftazidime/avibactam (Zavicefta™) and isavu-

such as countries’ GNI per capita. Pfizer partnersof its sample products are filed in less than 10

conazole (Cresemba®) for 51,000 cumulativewith Gavi to provide Pneumococcal Conjugate

access countries. Four of its sample products arepatients in low- and middle-income countries in

Vaccine (13-valent) (Prevnar 13®) to Gavi-eligible

filed for registration in at least one LIC.

2020.

and Gavi-transitioned countries at a public priceC.1.3 Filed to register on-patent vaccines in 24

C.2.2 Several strategies to expand access tovides evidence of patient reach and geographic

off-patent/generic medicinesreach for all its reported approaches. It commitsof USD 2.90 per dose until 2027. Pfizer proaccess countries on average
Pfizer has an average performance, filing three

Pfizer performs above average, with accessto supply 930 mn doses of its Pneumococcal

of its four relevant on-patent vaccines for regis-

strategies reported for four of its ten relevant

Conjugate Vaccine (13-valent) (Prevnar 13®) bytration in access countries. Its most widely filed

off-patent/generic medicines. It aims to expand

2027 through its partnership with Gavi.

relevant vaccine is the Pneumococcal Conjugate

access in low- and middle-income countries

Vaccine (13-valent) (Prevnar 13®) filed in 65

through donations and public/private partner-

access countries. Prevnar 13® is followed by theships. It provides evidence of patient and geo-meningococcal vaccine Nimenrix® , filed for reg-graphic reach for all its reported approaches.

Pfizer performs above average, with strategies

istration in 23 access countries, including LICs.

Pfizer takes part in the International Trachoma

reported in all four areas assessed. Pfizer ensures

Initiative (ITI) and donated 31 mn azithromycin

accurate demand planning and data analytics bytreatments to 12 countries in 2020. It extended

forecasting on a monthly and 24-month rollingits donation program until 2025. Through its

basis. Pfizer mitigates against shortage risks by

Pfizer performs above average, with access

Diflucan® Partnership Program, Pfizer distrib-

keeping buffer stocks for its finished products at

strategies reported for three of five relevant

uted 7mn doses of fluconazole to nine accesscountry-level, for APIs at a global-level, and manu-

on-patent medicines. It aims to expand accesscountries through governments and NGOs in

factures some of its APIs in-house. Pfizer reports

to its on-patent medicines in access countries

2019 and 2020.

one technology transfer initiative. Since 2014, it

C.2.1 Several strategies to expand access to
on-patent medicines

through equitable pricing policies, one priceper patient capitation model, and patient assis-

C.3

Several strategies to ensure continuous
supplyhas engaged in a public/private partnership in
C.2.3 Several strategies to expand access to
on-patent vaccines

tance programs. To set the prices of ceftazi-South Africa to enable a local partner to manufacture Pneumococcal Conjugate Vaccine (13-dime/avibactam (Zavicefta™) and isavucona-

Pfizer performs above average, with accessvalent) (Prevnar 13®). To mitigate against sub-zole (Cresemba®), Pfizer takes into account local

strategies reported for one of its four relevant

standard and falsified products, Pfizer maintains aeconomic conditions, the average income, andon-patent vaccines. It aims to expand access in

Disruption Program which identifies and disrupts

GDP growth. It allows for net price flexibility foraccess countries through equitable tiered pric-

online illicit sales. Pfizer uses serialisation withspecific procurement requests. Pfizer provides

ing, public/private partnerships, humanitar-

unique products identifiers and has a public coun-evidence of patient reach and geographic reachian emergency assistance settings and tenders.

terfeit awareness page.

C

APPROPRIATE ACCESS & STEWARDSHIP – STEWARDSHIP

Evaluated: stewardship activities relating to antibacterial & antifungal medicines globally
C.4

Comprehensive COI mitigation strategies

and/or include treatment guidelines for health-in place for its educational programmescare professionals: for all antibacterial medicines

C.7

Active in multiple AMR surveillance programmes; one openly shares raw data

Pfizer performs strongly in conflict of interestand isavuconazole (Cresemba®), by using data

Pfizer leads in this area. It is active in multiple(COI) mitigation for the five AMR-related edu-from its ATLAS surveillance programme in the

AMR surveillance programmes. It runs the multi-

cational programmes for HCPs assessed by thematerials.

national ATLAS programme, which is focused on

Benchmark. To mitigate COI for all five pro-resistance against its antibacterial and antifunMakes three types of brochure and/gal medicines in 81 countries and has been run-pendent third parties (BSAC, the University ofor packaging adaptations to facilitatening since 2004. Pfizer shares the raw data on

Dundee, EBRD, ISID and Micron) to develop theappropriate use by patientsthe AMR Register, an open-access data platform,

grammes, it provides financial resources to inde-programme.

C.6

Pfizer adapts packaging to facilitate the appro-

as well as the aggregated results on the ATLAS

priate use of azithromycin (Zithromax®) bywebsite and through peer-reviewed open-accessEngages in sales and marketing practices

patients. Pfizer performs strongly in this meas-

journal articles. For the remaining programmes,

to address appropriate useure, taking account of adherence to treatment,

only the aggregated results are shared throughPfizer performs above average in sales practices.

paediatric use and language. It adapts the pack-peer-reviewed open-access journal articles,

It reports that it partly decouples incentives foraging of azithromycin, named the Z-Pak, which

as well as on open-access data platforms forsales agents from sales volumes of its antibac-

facilitates patient adherence by organising

the SENTRY programme (an antifungal resist-terial and/or antifungal medicines. Its percent-the pill intake for each day, so that the patientance programme managed by JMI laboratories)

age of variable pay is capped at 30% and sales

knows exactly which pill(s) to take on which day

and the CANWARD programme (a national pro-targets are set at the national level. Its incen-

until the Z-Pak is completed. Moreover, Pfizer

gramme managed by the Canadian Antimicrobial

tives for sales agents in emerging markets inincludes a QR code on the packaging of azithro-

Resistance Alliance).

Asia are provided on the basis of confidentiality.

mycin as an oral suspension that directs patients

However, Pfizer does not reward its sales agentsto a video explaining how to administer the oral

based on antibacterial volumes sold in the UK.

suspension properly for adults and children. This

Pfizer engages in marketing practices thatis applied in Vietnam and the Philippines and theaim to address the appropriate use of its anti-

video will be played in the local language. Finally,

bacterial and/or antifungal medicines consist-

Pfizer has translated instructions on the packag-

ent with the approved indication. Its market-

ing to the local language in Japan.

C.5

ing materials reflect emerging resistance trends

25