Access to Medicine Index 2022 ▶ Company report cards

RA N KSCO R E13

2.93

12 (2021)

Boehringer Ingelheim
Stock exchange: N/A • HQ: Ingelheim am Rhein, Germany • Employees: 52,391

PERFORMANCE IN THE 2022 INDEX
13th place. Boehringer Ingelheim is a middle-performing
company. The company has an average performance inGovernance of Access and Research and Development but
performs below average in Product Delivery. Boehringer

How score was achieved
4.00

Governance of Access
2.23

Research & Development

3.02

Product Delivery

Ingelheim has improved its R&D access planning framework

0

1

but does not publicly disclose the patent status of its
products via Pat-INFORMED.

2

3

Average

Leader4

5

small-sized priority pipeline and has an average performance
Governance of Access: 12th place. Boehringer Ingelheim

in R&D capacity building.

has an average performance in this area. It has a clear
access-to-medicine strategy and discloses outcomes of its

Product Delivery: 14th place. Boehringer Ingelheim has aaccess-to-medicine activities, but it lacks a continuous systembelow average performance in this area. The company has

to monitor activities as part of its compliance framework foraccess strategies for all its products but lacks examples incountries in scope of the Index.

low-income countries. It builds capacity in supply chains, manufacturing and health systems, though some initiatives lackResearch & Development: 12th place. Boehringer Ingelheim

evidence of certain quality standards such as public disclosure

has an average performance in this area. It has introduced aof outcomes. The company shares intellectual property assets

structured access planning framework and applies this to allwith third party researchers but does not publicly disclose thelate-stage pipeline candidates. However, the company has apatent status of its products via Pat-INFORMED.

OPPORTUNITIES FOR BOEHRINGER INGELHEIM

CHANGES SINCE THE 2021 INDEX

Improve the quality of access plans for late-stage R&D projects. Boehringer Ingelheim• Newly demonstrates access-related incentives for senior-

has introduced a new policy to systemically plan for access before Phase II of clinicaldevelopment and has plans in place for all late-stage candidates analysed. For noncommunicable diseases the company’s access plans focus mostly on registration incountries in scope of the Index. For example, for projects such as iclepertin (BI 425809)
for schizophrenia and BI 456906 for diabetes, Boehringer Ingelheim can include moreaccess components such as equitable pricing and licensing in its plans.

level executives.
• Created a Vulnerability Framework with input from different
organisations to ensure that its access-to-medicine
strategies are reaching all vulnerable populations.
• Newly demonstrates evidence that sales incentives aredecoupled from sales volume targets.
• Improved access planning during R&D by broadening its

Improve transparency of the patent status of its products. Boehringer Ingelheim

framework and implementing it to its entire pipeline, as well

publicly commits to not file for or enforce patents in 61 countries within the scope of theas ensuring that all access planning begins in pre-clinicalIndex, including all Least Developed Countries and low-income countries and a subset oflower-middle income countries and upper-middle income countries. The company candisclose detailed patent information publicly, either on its website or via Pat-INFORMED,
including for its biological products.

development.
• Established an office in Kenya to serve some of the mostvulnerable communities in sub-Saharan Africa and exploring
equitable access initiatives in the region.
• Committed (together with Boehringer Ingelheim Stiftung)Improve access to products on the WHO Model List of Essential Medicines (EML).

EUR 150 million into antibiotic R&D of which EUR 40 million

Boehringer Ingelheim engages in equitable pricing for some of its products. The

is already invested in the Antimicrobial Resistance (AMR)

company has seven products on the WHO EML. The company can further expand access

Action Fund, joint venture Aurobac and invested in fiveto these products, such as dabigatran (Pradaxa®), for prevention of stroke, and afatinib
dimaleate (Giotrif®/Gilotrif®), for lung cancer, via equitable pricing in LICs. Boehringer

biotech companies.
• Created the investment vehicle Boehringer Ingelheim Social

Ingelheim can engage in non-exclusive voluntary licencing for patented medicines forEngagement, endowed with EUR 50 million to provide

type 2 diabetes mellitus, such as empagliflozin (Jardiance®).

financing for impact to social businesses in vulnerable
communities, as an extension of Making More Health.
• Launched the new cervical cancer screening initiative
Together Women Can in partnership with AMPATH in
Kenya.

17

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.

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.

Access to Medicine Index 2022 ▶ Company report cards

SALES AND OPERATIONSBusiness segments: Animal health,

M&A news: Boehringer Ingelheim signed anbiopharmaceutical contract manufacturing,

option to acquire Trutino Biosciences in Junehuman pharmaceutical and other sales.

2022.

Net sales by segment (2021) – in EUR

Therapeutic areas: Cardiometabolic diseases,

Human pharmaceutical

15.29 bn

Animal health4.30 bncancer immunology, central nervous system

Boehringer Ingelheim's products are sold in

Biopharmaceutical contract manufacturing 0.92 bn

diseases, immunology, oncology and respiratory

71 out of 108 countries in scope of the Index.

Other sales

0.03 bndiseases.

Boehringer Ingelheim has sales offices in 17

Discontinued operations

0.08 bn

Product categories: Animal health, biosimilars

countries, and sells via suppliers and/or pooled		and innovative medicines.

procurement in an additional 54 countries.

Total

Sales by geographic region
30

Net sales (Bn EUR)

Sales in countries in scope

20.62 bn

25
20
15
10
5
0

In scope, has sales offices
In scope, any sales

2017

2018

Asia/Africa/Australia

In scope, no sales

2019

2020
Europe2021
Americas

Not in scope

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

PORTFOLIO as selected for analysis by the Index

Boehringer Ingelheim has a total of 35 R&D projects in scope with two ofBoehringer Ingelheim has 20 medicines in scope, 15 of which are on patent.

these projects targeting priority diseases. Thirty-three R&D projects target

60% of these medicines (11) are on the WHO EML. In addition, the com-other diseases in scope. Of the projects targeting other diseases, the focus

pany markets one vector control product. The off-patent medicines target

is on oncology (19), kidney diseases (6), neurology (3), COPD (2), diabetes

mainly non-communicable diseases (NCDs) such as chronic obstructive(1) and heart disease (1). Eight R&D projects are in late-stage development

pulmonary disease and asthma (2), ischaemic heart disease and stroke (2)that target either a priority disease (1) or address a public health need inand diabetes mellitus (1). The on-patent medicines also target the same

LMICs (7).* Evidence of access planning was in place for 100% of these

NCDs as well as hypertensive heart disease (3) and cancer (1).

projects.

35 projects in the pipeline

21 products as selected for analysis by the Index†

2

Communicable** 0

Maternal and neonatal 0

Maternal and neonatal 033

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

1

0

0

0

2

Contraceptives

Addresses needs of LMICs*

9

3

3

1

0 16

Other projects in scope

16

1

0

0

0

*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 in17

the 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-Diagnostics
Other

‡

Total

1

Targets established R&D priorities

Other

0

Vaccines

WHO EDL

0

Total

0

Other***

0Registration/approval

50Phase III1

Phase II

8

4

Phase I7

off patent

Pre-clinical

Medicines on patent

Discovery

Non-EML

10

Breakdown of projects

1820

Non-communicableMultiple categories 001

Neglected tropical

WHO EML

Communicable**

Neglected tropical 0

15

0
0

0
1

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.

1

Access to Medicine Index 2022 ▶ Company report cards

Boehringer Ingelheim

GOVERNANCE OF ACCESSRANK 12SCORE 4.00

Has an access-to-medicine strategy with meas-

tries in scope of the Index. It shares the outcomesnal) covering third parties and in all countries

urable objectives, integrated within its overallof its access-to-medicine activities in a central-

where it operates, country risk-based assess-corporate strategy. Boehringer Ingelheim per-ised manner directly on its website and within its

ments and formal processes to ensure third-party

forms strongly. It has an Access to Healthcare

annual report.

compliance with company standards. It does

Approach, part of its "Sustainable Development

not, however demonstrate adequate evidence– For Generations" framework, which includes

Performs above average in responsible pro-of a continuous system to monitor activities. No

both human and animal health. The strategy cov-

motional practices. Boehringer Ingelheim’s sales

breaches in countries in scope of the Index wereers all therapeutic areas in which the company

agents are not solely incentivised on sales volume

publicly found in the period of analysis.

is involved, namely non-communicable diseases

targets. However, the company sets incentives(NCDs). The highest responsibility for access lies

based on sales targets at the individual level for

Publicly supports the Doha Declaration on

directly with the board.

agents. It publicly discloses information related

TRIPS and Public Health. Boehringer Ingelheim

to transfers of values to healthcare professionals

publicly shares support of the Doha Declaration

Provides evidence of financial or non-finan-

in countries in scope of the Index (e.g., paymentson TRIPS and Public Health. It views thecial access-related incentives at the executive

for attending events or promotional activities)

Declaration as a mechanism offering more juridi-

level. Boehringer Ingelheim performs above aver-according to law and industry association and has

cal certainty to countries which may intend to useage. It demonstrates evidence of access-related

global and local policies governing such trans-

the system. There is evidence of industry asso-

incentives for senior executives and in-country

fers to ensure compliance with the applicableciation lobbying on intellectual property and the

managers.

regulations.

usage of TRIPS flexibilities, namely of compulsory

Publicly discloses outcomes of its

Has compliance controls to ensure that gov-

tries in scope of the Index. As a member of theaccess-to-medicine activities. Boehringer

ernance efforts are not undermined byindustry association, Boehringer Ingelheim, like all

Ingelheim performs above average in transpar-

non-compliant or corrupt activities. Boehringer

other member companies in scope of the Index, isency of access activities. It publicly discloses

Ingelheim demonstrates evidence of the following

by default connected to this activity.

commitments, measurable goals, objectives andcomponents assessed by the Index: fraud-specifictargets for improving access to medicine in coun-risk assessment, audits (both internal and exter-

licensing, by national governments in some coun-

RESEARCH & DEVELOPMENTRANK 12SCORE 2.23

Access planning processes encompass all pro-dates covered by access plans. In this analysis,

Ingelheim does not disclose disaggregated R&D

jects in the pipeline. Boehringer Ingelheim has

Boehringer Ingelheim has seven projects in late-investment data to global health organisations.

a structured process in place to develop accessstage development, that target a disease and/orplans during R&D. The process is intended to be

product gap not yet established as a priority by

One R&D capacity building initiative included

applied to all R&D projects (both in-house andglobal health stakeholders. These projects are all

for analysis meets all Good Practice Standards.

collaborative) for diseases in scope of the Index.

deemed by the Index to offer a clear public health

Boehringer Ingelheim's performance is average

Boehringer Ingelheim begins developing accessbenefit for people living in LMICs.* Primarily,in this area. The number of initiatives meeting allplans for R&D projects before Phase II of clinicalthese projects have clinical trials in countries ininclusion criteria is lower than average and fewer

development.

scope of the Index and/or are first-in-class mol-initiatives meet all Good Practice Standards thanecules. The projects mainly focus on cancer andwhat is average for this indicator. Boehringer

A small-sized priority R&D pipeline comparedkidney diseases. Boehringer Ingelheim provides

Ingelheim's Research Beyond Borders (RBB) ini-

to peers. Boehringer Ingelheim has two projects,

evidence of access plans for all seven late-stage

tiative enables 30 research collaborations withincluding one late-stage candidate in its pipeline

projects. These plans focus mainly on registration

universities and research organisations in coun-that target a priority product gap. This project ispreparation in countries in scope of the Index.

tries in scope of the Index to advance drug

supported by an access plan.

discovery in areas of high unmet medical need.
Does not publicly disclose R&D investment

Many projects address a public health need indata disaggregated by disease category, prod-

LMICs,* with 100% (7/7) of late-stage candi-

uct type or phase of development. Boehringer

PRODUCT DELIVERYRANK 14SCORE 3.02

Public commitment not to enforce patents in

Countries and LICs in scope of the Index and apeers, Boehringer Ingelheim does not disclose

countries in scope. Boehringer Ingelheim publicly

subset of LMICs and UMICs.

the patent status of its products for diseases

commits to not file for or enforce patents. This19

in scope of the Index on their website nor incommitment applies to 61 countries within theDoes not publicly disclose information on pat-scope of the Index, of which all Least Developed

ent statuses on their website. Unlike all its*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.

Pat-INFORMED.

Access to Medicine Index 2022 ▶ Company report cards

Performs above average in terms of shar-

Has access strategies for some of its self-ad-

inclusive business models aimed at meeting theing intellectual property (IP) assets withministered products for some countries inaccess needs of populations at the base of thethird-party researchers. Boehringer Ingelheim

scope of this analysis. Boehringer Ingelheim has

income pyramid (including other underserved

engaged in three new IP-sharing agreements withan average performance in this area. The com-

populations) in LMICs. The Healthy Entrepreneurs

third-party research institutions or drug discovery

pany provides examples of access strategies insocial start-up trains over 8,000 entrepreneurs toinitiatives established during the current analysis

UMICs and LMICs for the five products assessed.

enable them to sell healthcare products in remoteperiod that meet all inclusion criteria for evalua-

It makes efforts to reach additional patients using

villages and reaches more than 10 million individ-

tion. The company also has existing agreements

pricing strategies that consider payers' ability touals on a yearly basis.

of this nature in place that were established

pay and additional access strategies. The com-

before the current Index cycle.

pany is able to provide evidence of patient reach

Has an average performance in ensuring contin-

for three products in UMIC and LMIC country

uous supply of medicines in LMICs. Boehringer

examples provided.

Ingelheim is involved in supply chain capacity

No use of licensing agreements. Boehringer
Ingelheim does not engage in voluntary licensing

building initiatives in LMICs. The company also
One of the three manufacturing capacity build-

has a system in place to work with relevant stake-ing initiatives included meets all Good Practiceholders to communicate issues that may affectNo evidence of new products in scope.

Standards. Boehringer Ingelheim's perfor-

the supply chain, manages a buffer stock of rel-

Boehringer Ingelheim did not disclose evi-mance is average in this area. The number ofevant products and is involved in technology

dence of filing for registration any new products.

initiatives meeting all inclusion criteria is aver-transfer initiatives. The company works with mul-Among old products, its most widely filed prod-

age but fewer initiatives meet all Good Practicetiple active pharmaceutical ingredient suppliers

uct, empagliflozin (Jardiance®), mainly used inStandards (GPS) than what is average for thisfor some products and otherwise keeps buffer

individuals with type 2 diabetes, has been filed forindicator. In the initiative that meets all GPS, thestocks to mitigate supply risks.

registration in 37 countries in scope of the Index,

company co-develops, and teaches, a compre-

three among the highest disease burden (Guyana,

hensive course on quality drug manufacturing in

Has a policy for reporting substandard and fal-

Sri Lanka and Mexico). Uganda and Yemen arecollaboration with the East China University ofsified (SF) medicines in countries in scope

the low-income countries where Boehringer

Science and Technology, Fudan University andof the Index in less than ten days. Boehringer

Ingelheim has registered its products analysed

the Shanghai Pharmaceutical School.

Ingelheim has a policy for reporting SF medi-

for products in scope of the Index.

under this indicator.

cines to national regulatory authorities within
One of the three supply chain capacity build-seven days. It discloses to the Index, but not pub-Has access strategies for its supranationally

ing initiatives included meets all Good Practice

licly, whether it has quicker reporting time frames

procured product in scope for this analysis.

Standards. Boehringer Ingelheim's performancefor cases that only require visual inspection to be

Boehringer Ingelheim has an average perfor-

is average in this area. The number of initiatives

confirmed.

mance in securing access for its product procured

meeting all inclusion criteria is average but fewer

supranationally. Boehringer Ingelheim supplies its

initiatives meet all GPS than what is average for

Donates in response to expressed need andrabies vaccine (Rabisin®), through PAHO, and it

this indicator. Healthy Entrepreneurs manages amonitors delivery. Boehringer Ingelheim has

shared evidence of access strategies in countries

fully integrated end-to-end supply chain throughpublic policies and supply processes in place tonot eligible to benefit from such procurement.

training community health entrepreneurs on

ensure ad hoc donations are carried out rapidly in

The company provides evidence of an increase inhealth and business in addition to how to educate

response to expressed need, and it monitors theanimal vaccinations reach over the last two years.

and advise its customers.

delivery of donations until they reach the patient.

Has few access strategies for its healthcare

Two of the four health systems strengthen-Publicly commits to the achievement of elim-

practitioner-administered products in scopeing initiatives included meet all Good Practiceination, eradication or control goals in oneof this analysis. Boehringer Ingelheim performs

Standards. Boehringer Ingelheim's performance

structured donation programme for neglected

below average in this area. It provides evidence

is average in this area. The number of initiatives

tropical diseases or malaria. Boehringerof access strategies in UMICs and LMICs, but

meeting all inclusion criteria is average but fewer

Ingelheim is publicly committed to supporting theno evidence for LICs for the two products ana-

initiatives meet all GPS than what is average forgoal of zero human dog-mediated rabies deaths

lysed. It makes efforts to reach additional patients

this indicator. For example, the Pakistan-Rabies-

by 2030: it includes donating the rabies vaccine

using pricing strategies that consider the payer's

Free Campaign is a health systems strengthening(Rabisin®) in six countries in scope of the Index.

ability to pay and by entering into collaboration

initiative done in collaboration with the Indus

with a public-private partnership. For example,

Hospital in Karachi that aims to involve com-

Boehringer Ingelheim has entered into collab-

munities in mass rabies vaccination campaigns

oration with The Defeat-NCD Partnership toand ultimately reduce the incidence of rabies in

improve access and affordability to its quality

Pakistan. This initiative meets all GPS.

assured medicines across low resource countries.

20

Practically, institutions are now able to pro-

Has engaged in scaling up three and pilot-

cure these medicines through The Defeat-NCD

ing two inclusive business models. Boehringer

Partnership’s Essential NCD Supplies Facilities.

Ingelheim performs above average in the use of

Access to Medicine Index 2022 ▶ Company report cards

RA N KSCO R E

15

2.60

19 (2021)*

Bristol Myers Squibb
Stock exchange: NYSC • Ticker: BMY • HQ: New York, United States • Employees: 32,200

PERFORMANCE IN THE 2022 INDEX
15th place. Bristol Myers Squibb performs below average in
two of three Technical Areas. The company has performed
below average for access strategies, yet it performs strongly
in health systems strengthening. It has improved in accessHow score was achieved
3.86

Governance of Access
1.80

Research & Development

2.69

Product Delivery

planning in R&D but has a small-sized priority pipeline.

01

Governance of Access: 14th place. Bristol Myers Squibb has

2

3

Average

Leader4

5

an average performance in this area. It has an access-to-medicine strategy integrated within the overall corporate strategy.
It provides evidence of financial and non-financial access-re-

Product Delivery: 15th place. Bristol Myers Squibb has a below

lated incentives at the executive level but does not disclose

average performance in this area. The company has strength-

whether in-country managers or the CEO are also incentiv-

ened its performance in manufacturing capacity building byised toward access goals.

participating in technology transfers, yet its performance inequitable access strategies is below average for certain prod-

Research & Development: 17th place. Bristol Myers Squibb

ucts. It engages in high quality health systems strengthen-performs poorly in this area. The company has a structured

ing initiatives but lacks involvement in supply chain capac-

access planning process in place, but it does not apply this toity building. The company has non-exclusive voluntary licens-all late-stage candidates. The company has an average perfor-

ing agreements in place for two compounds to enable genericmance in R&D capacity building.

supply in LMICs.

OPPORTUNITIES FOR BRISTOL MYERS SQUIBBCHANGES SINCE THE 2021 INDEX

Develop access-related incentives for senior management. Bristol Myers Squibb has• Launched the first ever Global Access Report, which

an access strategy linked to sustainability goals, which includes all therapeutic areas inhighlights Bristol Myers Squibb’ efforts and progress

which the company is involved. Financial and non-financial incentives for the CEO andtowards advancing access to healthcare and health equity

in-country managers can be tied to the achievement of the sustainability goals underglobally.

their access strategy. The incentives can also be oriented toward long-term goals.

• Newly demonstrates evidence that sales agent incentives

Ensure all late-stage R&D projects have comprehensive access plans. Bristol Myers• Introduced a structured framework to include accessare decoupled from sales volume targets.
Squibb can develop access plans for all projects from Phase II of clinical development.
The company has plans in place for 73% of late-stage projects. These plans primarily

planning in all its pipeline projects.
• Started a new capacity building initiative with multiple

consist of commitments to registering products in countries where clinical trials for thatpartners to support sustainable and effective administration

product have been conducted. Access plans for nivolumab (Opdivo®) and pomalidomide

of innovative therapies for the treatment of cancer in(Pomalyst®), indicated for multiple cancer types, can also include additional accesscomponents such as equitable pricing.

LMICs.
• Newly licensed the >4000-member library to Medicinesfor Malaria Venture (MMV) in addition to donating USD 1

Improve access to on-patent cancer drugs on WHO Model List of Essential Medicines(EML). Bristol Myers Squibb has four on-patent products on the WHO EML, including
dasatinib (Sprycel®), a product indicated for imatinib-resistant chronic myeloid

million to support the missions of both MMV and Drugs for
Neglected Diseases initiative (DNDi).
• Joined the Access to Oncology Medicines (ATOM) Coalition,

leukaemia. The company provides access to dasatinib in at least one upper-middle
income country via an equitable pricing strategy and to low-income countries and lower-a new global initiative that aims to improve access toessential cancer medicines in LMICs.

middle income countries via the Max Foundation donation programme. Bristol Myers• Acquired a global exclusive license to develop, manufacture

Squibb can expand access to the product via registration, equitable pricing and non-and commercialise Rockefeller’s novel monoclonal antibody

exclusive voluntary licensing agreements in more countries, especially those where theduo treatment against COVID-19.

burden of disease is the highest, such as Afghanistan, Haiti and Ethiopia.

21

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.

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,
a direct comparison with Bristol Myers
Squibb's previous rank is not possible.