The Access to Medicine Foundation says pharmaceutical companies face gaps in making new medicines accessible. Its 2026 report finds that innovation is outpacing access to treatment in low- and middle-income countries.
The foundation released its 2026 Index on Tuesday during a webinar marking 20 years of tracking pharmaceutical companies’ efforts to advance global health equity.
The report found that access plans now cover 69 per cent of pharmaceutical companies’ late-stage pipeline candidates—more than three times the proportion recorded in 2018.
However, the foundation said progress remained uneven, particularly for non-communicable diseases (NCDs), where 43 per cent of access plans focused solely on product registration.
The Index noted that regulatory approval alone was not enough to guarantee patient access. It said companies needed strategies addressing affordability, availability and reliable medicine supply.
The foundation urged pharmaceutical companies to make access planning standard across their product pipelines and work with local partners to identify barriers before medicines reach the market.
On cancer treatment, the report found that oncology products accounted for about half of all pharmaceutical clinical candidates, making cancer the leading area of research and development.
Although access plans covered 65 per cent of oncology pipeline candidates, strategies were in place for 74 per cent of assessed cancer products in lower-middle-income countries, the report said.
“In low-income countries, however, access strategies covered only 19 per cent of assessed cancer products, exposing significant geographical inequalities in access to emerging treatments,” it said.
The foundation recommended stronger partnerships with cancer programmes and treatment centres in developing countries to address barriers to screening, diagnosis and affordability, as well as gaps in healthcare capacity.
On inclusive business models, the report identified six pharmaceutical companies with multi-country initiatives designed to reach underserved populations, compared with five in 2024.
It said the six companies’ models collectively covered all 113 low- and middle-income countries included in the Index. However, limited reporting at the product level made their actual impact difficult to establish.
The report also identified 25 diabetes research and development projects across six pharmaceutical companies, with innovation heavily focused on glucagon-like peptide-1 (GLP-1) medicines.
Despite increased research into newer diabetes treatments, the foundation identified access to insulin as a major challenge, particularly for patients in lower-income countries.
It urged global health stakeholders to prioritise affordable, reliable insulin supplies while ensuring that newer treatments and technologies did not widen existing health inequalities.
Commenting on the findings, Jayasree Iyer, Chief Executive Officer of the Access to Medicine Foundation, said two decades of industry assessment had strengthened efforts to address persistent barriers to access.
“Twenty years of progress have put us in a stronger position than ever to tackle persistent gaps in access.
“The Index has shown what works, companies have more tools at their disposal and access is increasingly being considered earlier,” she said.
Iyer said the opportunity now was to build on existing progress and extend effective access strategies to more patients, particularly in underserved communities.
Claudia Martínez, the foundation’s Director of Research, said the industry had recorded important developments, including sustainable business models, product approvals, pipeline innovations and new licensing agreements.
“The 2026 Index shows some important shifts in how companies are approaching access. But these efforts are still concentrated among too few companies, products and diseases,” she said.
Martínez said pharmaceutical companies needed to expand successful approaches across the industry so more patients could benefit from advances in medicine development and delivery.
In the Index, Novartis ranked first for the second time, followed by GSK. Both companies retained their positions across all three technical areas assessed.
AstraZeneca ranked third, Sanofi fourth and Bayer fifth. Boehringer Ingelheim and Roche tied for sixth, while Pfizer ranked eighth.
The foundation said the 2026 assessment placed greater emphasis on implementation and measurable outcomes. It used fewer indicators to distinguish between companies’ commitments and actual performance.
The Index covered the period from June 1, 2024, to May 31, 2026, and assessed companies across three areas: Governance of Access, Research and Development, and Product Delivery.
