Access to Medicine Index 2022 ▶ Company report cards

RA N KSCO R E6

3.62

4 (2021)

Pfizer Inc
Stock exchange: NYSE • Ticker: PFE • HQ: New York, New York, United States • Employees: ~79,000

PERFORMANCE IN THE 2022 INDEX
6th place. Pfizer leads in Governance of Access, excelling in its
approach to incentivising responsible promotional practices.
It performs well in the other two Technical Areas, engaging in
high-quality capacity building initiatives across all fields, andHow score was achieved
4.57

Governance of Access
3.15

Research & Development

3.61

Product Delivery

performing well in access planning and strategies.

0

1

Governance of Access: 1st place. Pfizer leads in this area. It

2

3

Average

Leader4

5

has an integrated access-to-medicine strategy with directboard-level responsibility for access to medicine and incentives for its senior executives, including the CEO, and in-country and regional managers. It discloses outcomes of its

in its pipeline. The company has an average-sized priority

access-to-medicine activities, has a robust set of compliancepipeline and performs well in R&D capacity building.

controls to mitigate the risk of non-compliance in countries
in scope of the Index and demonstrates best responsible pro-

Product Delivery: 6th place. Pfizer performs well in this area.

motional practices relative to other companies in scope of the

The company has comprehensive access strategies in place

Index.

for its products, but for healthcare-practitioner administered products the strategies focus mostly on upper-middle

Research & Development: 5th place. Pfizer performs well inand lower-middle income countries. It engages in high-quality

this area. Pfizer has a structured access planning framework

capacity building initiatives across all fields (i.e., manufactur-and has access plans for the majority of late-stage candidates

ing, supply chain and health systems strengthening).

OPPORTUNITIES FOR PFIZERCHANGES SINCE THE 2021 INDEX

Improve access planning for R&D projects for non-communicable diseases. Pfizer has• Launched ‘An Accord for a Healthier World' in May 2022,

access plans in place for 64% of projects for non-communicable diseases. These plans

which commits to provide all its current and future patentprimarily focus on registration preparation in countries in scope. Pfizer can establish

protected medicines and vaccines available in the Unitedaccess plans for all projects from Phase II onwards, including danuglipron for type

States or European Union on a not-for-profit basis to 45

2 diabetes. Furthermore, it can enhance existing plans to incorporate more accesscomponents such as equitable pricing and sustainable supply.

LMICs.
• Received FDA Emergency Use Authorisation for the oral
antiviral medicine nirmatrelvir/ritonavir (Paxlovid®) andExpand technology transfers to manufacturers in more LMICs. Pfizer has transferredtechnology for the on-patent pneumococcal vaccine (Prevnar 13®) and the COVID-19

signed a procurement agreement with UNICEF to supply up
to 4 million treatment courses in LMICs.

vaccine (Comirnaty®) to manufacturers in Brazil and South Africa. Pfizer can partner• Adopted the ESG Scorecard, which will be used as a tool towith more manufacturers in LMICs to build manufacturing capacity and improve local

assist in determining the funding for the annual short-term

availability of additional products such as subcutaneous depo medroxyprogesterone
acetate (Sayana Press®), a long-acting reversible contraception.

incentive plan.
• Received FDA regulatory approval for its COVID-19 vaccine,(Comirnaty®) and filed for registration in 37 countries in

Measure and share outcomes of An Accord for a Healthier World. In 2022, Pfizer
launched its An Accord for a Healthier World which aims to provide all its patented

scope of the Index.
• Established new COVID-19 partnerships with UPS

medicines and vaccines at not-for-profit prices to 45 lower-income countries. To scale

Foundation, Zipline, and Global Environment andup this initiative and support integration into local health systems, Pfizer can track andTechnology Foundation among others to address vaccine

share both short- and long-term patient outcomes as part of its impact evaluation ofthis programme, in addition to outcomes such as patient reach and product volumes
sold.

supply and delivery issues in LMICs.
• Supplied its COVID-19 vaccine (Comirnaty®) through the
COVAX facility and pledged to provide 2 billion doses to
LMICs in 2021 and 2022.

Expand access to on- and off-patent cancer treatments to low-income countries.
Pfizer has access strategies for four of its cancer treatments, including on-patentproduct palbociclib (Ibrance®) for breast cancer and off-patent product vincristine212• Invested USD 100 million into the newly launched
Antimicrobial Resistance (AMR) Action Fund.
• Signed a non-exclusive voluntary licensing agreement with

(Vincristine) for leukaemia, in upper-middle income countries and lower-middle income

the Medicines Patent Pool (MPP) for nirmatrelvir/ritonavircountries. Pfizer can expand access to these products in low-income countries as part of(Paxlovid®), used as an oral COVID-19 treatment. This

its commitment to An Accord for a Healthier World.

agreement covers 95 countries.

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: Biopharmaceutical products

Pfizer's products are sold in 98 out of 108

and consumer health.

countries in scope of the Index. Pfizer has sales

Revenue by segment (2020) – in USD

Therapeutic areas: Hospital care, immunology,

offices in 27 countries, and sells via suppliers

Biopharmaceutical products

inflammation, internal medicine, oncology, rare

and/or pooled procurement in an additional 71		diseases and vaccines.

countries.

Total

41.91 bn
41.91 bn

M&A news: Pfizer acquired Arena
Pharmaceuticals in March 2022 for USD 6.7
billion.

Sales by geographic region
100

Revenue (Bn USD)

Sales in countries in scope

80
60
40
20
0

In scope, has sales offices
In scope, any sales

2017
USA

In scope, no sales

2018

2019

2020

2021

International

Not in scope

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

PORTFOLIO as selected for analysis by the Index

Pfizer has a total of 57 R&D projects in scope with 21 of these projects targeting priority diseases. The other 36 R&D projects target other diseases
in scope. Of the projects targeting priority diseases the focus is on coronaviral diseases (six projects) and lower respiratory tract infections (5). Of
the projects targeting other diseases in scope, the focus is on oncology(22).
Twenty-six R&D projects are in late-stage development that target eithera priority disease (13) or address a public health need in LMICs (13).*
Evidence of access planning is in place for 85% of these projects: 13 targeting a priority disease and nine addressing a public health need in LMICs.

Pfizer has 84 medicines in scope, 18 of which are on patent, and five vaccines.
56% of the medicines (47) are on the WHO EML. In addition, the company
markets four contraceptive methods and devices. The off-patent medicines
target communicable diseases (CDs) (15) such as HIV/AIDS (4) malaria (3) andtuberculosis (5); non-communicable diseases (NCDs) (46) such as cancer (26),cardiovascular diseases (10) and mental health conditions (3). One off-patent medicine is indicated for the treatment of the neglected tropical diseasesoil-transmitted helminthiasis. The on-patent medicines target CDs such as
respiratory infections (3), HIV/AIDS (1) and NCDs such as cancer (12), stroke(1) and unipolar depressive disorders (1). Pfizer's preventative vaccines (5) target CDs such as meningitis (3), lower respiratory infections and COVID-19.

57 projects in the pipeline

93 products as selected for analysis by the Index†
15

Communicable**133

Non-communicable

660Multiple categories 1
0

20
30
40
50
projects in the pipeline

20

40
60
80
100
products on the market

Phase I

Phase II

Phase III

Registration/approval

Other***

2

2

3

7

3

0 21

Total

off patent

2

16

18

45 21

66

Total

Pre-clinical4

Medicines on patent

Other

Discovery

Breakdown of products
WHO EDL

10

Breakdown of projects

Vaccines

4

1

5

Contraceptives

3

1

4

Addresses needs of LMICs*

12

9

3

1

0 25

Diagnostics

Other projects in scope

4

4

2

1

0

Targets established R&D priorities

213

Maternal and neonatal

Non-EML02

Non-communicable1

Multiple categories

Neglected tropical

WHO EML

Maternal and neonatal

24

Communicable**

7

Neglected tropical*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 in11

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-

Other

‡

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

Pfizer Inc

GOVERNANCE OF ACCESSRANK 1SCORE 4.57

Has an access-to-medicine strategy with meas-

public health, including new commitments in

Pfizer performs strongly, demonstrating evi-

urable objectives, integrated within its overall

response to the COVID-19 pandemic, measur-

dence of all components looked for by the Index:

corporate strategy. Pfizer performs strongly. Itsable goals, objectives and targets for improving

fraud-specific risk assessment, country risk-based

access strategy is integrated within its Purpose

access to medicine in countries in scope of theassessment, audits (both internal and external,

Blueprint, which outlines Pfizer's strategic direc-

Index. It facilitates accountability and transpar-covering third parties and in all countries where ittion, and covers all therapeutic areas in which theency by consistently sharing the outcomes of its

operates), formal processes to ensure third-party

company is involved, including rare diseases. The

access-to-medicine activities, including its pro-compliance with company standards and a con-highest responsibility for access lies directly withgress on SDG3-related targets, in a centralised

tinuous system to monitor activities. No breaches

Pfizer's executive management team with board

manner within its ESG Report.

in countries in scope of the Index were publicly

oversight, namely with the Corporate Governancefound in the period of analysis.
Performs well in responsible promotional& Sustainability Committee.

practices. Pfizer’s sales agents are not solely

Publicly supports the Doha Declaration on

Provides evidence of financial and non-financial

incentivised on sales volume targets. The com-

TRIPS and Public Health. Pfizer publicly sharesaccess-related incentives at the executive level.

pany does not set incentives at the individual

support of the Doha Declaration on TRIPS and

Pfizer performs strongly. It incentivises its seniorlevel. It has a global policy on interactions with

Public Health, but expresses reservations on its

executives and in-country managers to perform

healthcare professionals, but does not publicly

provisions, namely on the use of compulsory

on access to medicine with financial and non-fi-

disclose information related to transfers of values

licensing. There is evidence of industry associa-

nancial rewards. The CEO also has access-related

to healthcare professionals in countries in scopetion lobbying on intellectual property (IP) and the

incentives linked to the Purpose Blueprint goals,of the Index (e.g. payments for attending events

usage of TRIPS flexibilities, namely of compulsory

including improving access through partnerships.

or promotional activities), unless required by law

licensing, by national governments in some coun-or by local regulations.

tries in scope of the Index. As a member of the

Publicly discloses outcomes of its

industry association, Pfizer, like all other member

access-to-medicine activities. Pfizer performs

Has a robust set of compliance controls tocompanies in scope of the Index, is by default con-strongly in transparency of access activities.

ensure that governance efforts are not under-

nected to this activity.

It publicly discloses its commitment to global

mined by non-compliant or corrupt activities.

RESEARCH & DEVELOPMENTRANK 5SCORE 3.15

Access planning processes encompass all pro-

was still in development. The agreement allows

data disaggregated by disease category, prod-

jects in the pipeline. Pfizer has a structured

sub-licensees to produce generic versions of the

uct type or phase of development. Pfizer does

process in place to develop access plans during

drug for supply in countries in scope of the Index.

not disclose disaggregated R&D investment data

R&D. The process is intended to be applied to all

to global health organisations.

R&D projects (both in-house and collaborative)

Many projects address a public health need infor diseases in scope of the Index.

LMICs,* with 69% (9/13) of the late-stage pro-Three of the five R&D capacity building ini-

jects covered by access plans. In this analysis,

tiatives included meet all Good Practice

An average-sized priority R&D pipeline com-

Pfizer has 13 late-stage R&D projects that target aStandards. Pfizer's performance is above aver-pared to its peers, with access plans in placedisease and/or product gap not yet established asage in this area. The number of initiatives meetingfor 100% (13/13) of the late-stage candidates.

a priority by global health stakeholders. These pro-

all inclusion criteria is higher than average andPfizer has 21 projects including 13 late-stage

jects are all deemed by the Index to offer a clear

more initiatives meet all Good Practice Standards

candidates in its pipeline that target a prior-public health benefit for people living in LMICs.*

than what is average for this indicator. For exam-

ity product gap. These projects focus mostly on

Primarily, these projects have clinical trials in coun-ple, in collaboration with the Wellcome Trust,

lower respiratory tract infections and coronaviraltries in scope of the Index or are first-in-classthe SPIDAAR program (Surveillance Partnershipdiseases. All of Pfizer’s 13 late-stage candidates

molecules. Most target cancer. Pfizer provides evi-to Improve Data for Action on Antimicrobial

targeting a priority product gap have access plans

dence of access plans for nine of these projects.

Resistance) builds antimicrobial resistance (AMR)

in place. Notably, Pfizer signed a non-exclusive

These plans focus mainly on registration prepara-

surveillance capacity in Africa by tracking resist-voluntary licensing agreement with the Medicinestion in countries in scope of the Index.

ance patterns to better understand the burden of

Patent Pool (MPP) for its COVID-19 antiviral nirmatrelvir (PF-07321332) when the compound214*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 to

AMR on patients living in LMICs.
Does not publicly disclose R&D investment

patients in LMICs. Projects in the clinicalphase of development were included forthis analysis.

Access to Medicine Index 2022 ▶ Company report cards

PRODUCT DELIVERYRANK 6SCORE 3.61

Public commitment not to enforce patents inin scope of this analysis. Pfizer's performance

The number of initiatives meeting all inclusion cri-countries in scope. Pfizer publicly pledges not tois above average in this area.* The company

teria is higher than average and more initiatives

enforce patents in Least Developed Countries.

provides examples of access strategies whichmeet all GPS than what is average for this indica-consider affordability in both UMICs and LMICs

tor. For example, the Ghana Sickle Cell Disease

Publicly discloses information on patent status.

for the five products assessed, yet falls short at

Newborn Screening and Comprehensive Care

Like most of its peers, Pfizer publicly discloses

providing examples for LICs. It makes efforts to

Program seeks to advance the study and treat-

the patent statuses for small molecules in scope

reach additional patients using pricing strate-

ment of sickle cell disease (SCD) across Ghana

via the Pat-INFORMED database. It discloses thegies considering relevant payers' ability to pay.

and, ultimately, other countries in sub-Saharanpatent status of its entire small molecule port-

For example, while Pfizer is negotiating with the

Africa, by piloting and testing a newborn screening

folio. The information includes filing date, grantnational authority in Ghana for the inclusion ofprogram for SCD including introducing treatment

number, grant date and jurisdiction.

the ceftaroline fosamil (Zinforo®) in the National

protocols and understanding the willingness andInsurance Scheme, the company has initiated aability of families to enroll in follow-up care.

Performs above average in terms of sharing

patient affordability programme in 2021, which

intellectual property (IP) assets with third-

offers the product at 50% of the total cost andHas engaged in scaling up four inclusive busi-

party researchers. Pfizer engaged in two newpatients are allowed to complete payment overness models but has not shown evidence of its

IP-sharing agreements with third-party research

60 days. Pfizer provides evidence of how patient

involvement in piloting any new inclusive busi-

institutions or drug discovery initiatives estab-reach has been increased through this approach.

ness models that meet all inclusion criteria.

lished during the current analysis period that

Pfizer performs average in the use of inclusive

meet all inclusion criteria for evaluation. The

Has access strategies for most of its self-admin-

business models aimed at meeting the accesscompany does have existing agreements of thisistered products in the scope of this analysis.

needs of populations at the base of the income

nature in place that were established before thePfizer performs above average in this area. For

pyramid (including other underserved popula-current Index cycle and meet all inclusion criteria

four of the five products assessed, the company

tions) in LMICs. The Pfizer Foundation supported

for evaluation.

provides examples of access strategies in coun-

the development and implementation of a dengue

tries of all assessed income levels (UMIC, LMIC,

reduction programme through Reach52. Reach52

Uses licensing to enable generic supply. Pfizer

LIC), including efforts to reach additional patients

aims to bring high-quality healthcare to remotehas one non-exclusive voluntary licensing agree-using pricing strategies considering relevant pay-

and rural areas through data-driven programs thatment in place for one compound (for diseases

ers' ability to pay for the treatments. For example,

leverage a network of community health workers

in scope). Its licence for nirmatrelvir/ritonavir

Pfizer Mexico implemented a pricing strategy for

empowered by Reach52’s digital health platform.

(Paxlovid®), agreed with 38 sublicensees, encom-

lorlantinib (Lorbrena®) as second line of NSCLC

passes 95 countries, with 93 countries relevant totreatment that considers public sector afforda-

Performs above average in terms of ensuring

the Index, including 66 middle income countries.

bility. While in the private market, Pfizer Mexico

continuous supply of medicines in LMICs. Pfizer

offers tiered discounts for lorlantinib based on theis involved in technology transfers with third-

Filed to register new products in 14 countries

remaining insurance policy coverage from insur-

party manufacturers in LMICs, and has a system

in scope on average. Pfizer did not disclose evi-

ance providers and the ability of patients to pay,in place to work with relevant stakeholders todence of filing for registration any of its newreceiving first line and subsequent lines of NSCLC

communicate issues that may affect the supply

products in more than half of the top ten high bur-treatment. The company provided evidence of

chain, produces the majority of its active pharma-den countries (for products that could be assessed

patient reach increase for three products in UMIC

ceutical ingredients in-house, manages a buffer

with available global burden of disease data, whichand LMIC country examples.

stock of relevant products and is involved in sup-excludes COVID-19). Among new products, its

ply chain capacity building initiatives.

most widely registered is the COVID-19 vaccine

All five manufacturing capacity building ini-

(Comirnaty®), rapidly authorized in 37 countries intiatives included for analysis meet all GoodHas a policy for reporting substandard and fal-scope of the Index. Bevacizumab-bvzr (Zirabev),

Practice Standards. Pfizer is a leader. The num-sified (SF) medicines in countries in scope ofindicated for colorectal cancer among other can-ber of initiatives meeting all inclusion criteria is

the Index. Pfizer has a policy for reporting SF

cer types, has been filed in four of the top ten

higher than average and more initiatives meet all

medicines to the relevant national health author-

high burden disease countries such as Democratic

Good Practice Standards (GPS) than what is aver-ities but does not specify time frames. Instead,

People's Republic of Korea, Thailand and Ukraine.

age for this indicator. For example, the company

Pfizer reports that it follows locally mandated

is working with both The Biovac Institute in Southtime frames. It does not provide evidence of

Has access strategies for all supranationally pro-

Africa as well as Eurofarma in Brazil to transfer

shortened reporting time frames for cases which

cured products in scope for this analysis. Pfizer

technology to manufacture the COVID-19 vac-

only require visual inspection to be confirmed.

performs above average in securing access for its

cine for distribution in the African Union and Latin

products procured supranationally. For the five

America respectively.

demonstrates strategies both in countries eligi-

Two of the five supply chain capacity build-and supply processes in place to ensure ad hoc

ble for supply from such procurers and in at leasting initiatives included meet all Good Practice

donations are carried out rapidly in response to

one non-eligible country. For example, the com-

Standards. Pfizer's performance is above aver-

expressed need, and it monitors the delivery ofpany supplied COVID-19 vaccine (Comirnaty®)

age in this area. The number of initiatives meeting

donations.

in Rwanda via multiple supply pathways, includ-

all inclusion criteria is higher than average but an

ing via the COVAX Facility. This supply supported

average number of initiatives meet all GPS for

Publicly commits to the achievement of elim-

the local government in achieving their target

this indicator. Pfizer has partnered with Zipline, toination, eradication or control goals in one

vaccination rate aligned with local policy recom-

test and develop an end-to-end distribution solu-

structured donation programme for neglected

mendations. The price offered is a not-for-profit

tion for COVID-19 vaccines in Ghana in order totropical diseases or malaria. Pfizer publicly

price and consistent across all supply pathways.

safely distribute these to the last mile and reduce

commits to contributing to the elimination of tra-In 2021, around 7.4 million doses were supplied inwaste to expiry. This initiative meets all GPS.

choma by donating azithromycin (Zithromax®)

support of the government's vaccination program.

from 1998 to 2030 in 29 countries in scope ofAll five health systems strengthening initiatives

215

Donates in response to expressed need andmonitors delivery. Pfizer has public policies

products assessed in this category, the company

Has access strategies for the majority ofincluded for analysis meet all Good Practice

healthcare practitioner-administered productsStandards. Pfizer is one of the leaders in this area.

* The description of Pfizer’s performancein PP4 (HCP-administered products) was
corrected from "average" to "above aver-age" on 1 Dec 2022. This typographicalerror did not impact the underlying analysis or scoring.

the Index.