Co-Author Shrestha Saha
Market Access is meant to ensure that the right treatment find its way to the right patient at the right time and at a reasonable price. Market Access Strategy enables a pharma company to ensure its product is accessible to patients and can be paid for under the healthcare systems of different countries. Top Pharma Multinational Corporations (MNCs) are systematically assessed for their global access strategies through the Access to Medicine Index (ATMI) developed by Access to Medicine Foundations of the Netherlands. 2024 Access to Medicine Index ranked 20 of the world’s largest research-based pharmaceutical companies on their efforts to improve access to ‘medicines’, ‘vaccines’, and ‘diagnostics’ in low- and middle-income countries. No comparable framework captures information regarding Indian pharmaceutical companies given the fact that India is recognized as the ‘Pharmacy of the World’ due to contribution of these pharma companies.
ATMI Analytical Model covers 3 Technical Areas, 15 Priority Topics, and 32 Performance Indicators. Governance of Access as a Technical Area comprises 3 Priority Topics namely Responsible Business Practices, Governance and Strategy, and Measuring and Reporting Patient Reach. Research and Development (R&D) as a Technical Area comprises 3 Priority Topics namely Product Development, Access Provisions in R&D, and Building R&D Capacity. Product Delivery as a Technical Area comprises 9 Priority Areas namely Registration, Equitable Access Strategies and Outcomes, Intellectual Property Strategy, Licensing Quality, Product Donations, Inclusive Business Models, Quality and Supply, Local Manufacturing, and Health System Strengthening.
Efforts of top Indian pharma companies are encouraging, e.g., On Governance of Access, Mission Statement of Sun Pharma emphasizes on leveraging its resources to address community needs, aligning business with social responsibility. CSR initiative of the company through Programs like the Malaria Elimination Demonstration Project (MEDP) and Mobilie Healthcare Units (MHUs) showcase efforts to enhance healthcare access in underserved regions. For FY24, the company had 56.0 per cent directors as independent directors, with 67.0 per cent possessing pharmaceutical expertise. Divi’s Labs mainly emphasize on In-licensing agreements with companies like Merck & Co. and AstraZeneca to bring products to the Indian market. Cipla demonstrates a commitment to access through initiatives like the Cipla Global Access (CGA) business, which supplies essential medicines for HIV, Tuberculosis, and Malaria in Low- and Middle-Income Countries (LMICs).
For stakeholder engagement, Sun Pharma collaborated with NGOs and government bodies. The Company published annual sustainability and CSR reports, detailing their initiatives and impact, demonstrating a commitment to transparency. From CSR initiatives of the company, over 1 million people benefited by March 31, 2024. In FY24, people impacted (230,429), Villages impacted (1,458), Curative care patients impacted (198,786), and Families impacted (2,713) indicate a focus on measuring outreach. Torrent Pharma demonstrates a commitment to healthcare access through its flagship CSR initiative, REACH (Reach Each Child), and partnerships with organisations like the U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC). Torrent also reported that its REACH Program has screened over 1.5 lakh children, with more than 70,000 children brought out of malnutrition and anaemia across 1,600+ villages but a detailed, disaggregated data on patient by region, disease, or income level is not publicly available.
Through CSR-led initiatives like Purple Health, Dr. Reddy’s has provided primary care access to over 1.28 million people. The Company has fixed a timeline of 2027 by which 25.0 per cent of its new-launches to be first-to-market. Mankind Pharma provided free health check-ups and medical consultations to thousands of pilgrims at Mahakumbh 2025 (the world’s largest human gathering) with its 45-day healthcare mission. The company supported various CSR projects benefiting over 40,000 individuals. Zydus Lifesciences launched Ujvira brand for the treatment of breast cancer in FY22 which made the treatment affordable to larger pool of patients as it is the world’s first biosimilar of an antibody drug conjugate – Kadcyla. CSR initiatives of Lupin including the Lupin Human Welfare and Research Foundation have supported over 180,000 migrants, besides serving patients in 100 countries and reaching 1420,000+ patients by FY24.
Regarding Research and Development (R&D), top pharma companies in India are increasing their investment in R&D, e.g., Lupin invested 8.0 per cent of its revenue, i.e., ₹17,672 Mn in FY25 (up from 7.8 per cent of revenue or ₹15,264 Mn in FY24) that underscores the company’s continued commitment to innovation-led growth. Lupin has developed innovative products, including complex generics and biosimilars, with a focus on areas like respiratory, ophthalmology, and women’s health. Lupin has developed affordable versions of critical medications, such as first-line anti-TB drugs. The company has built strong R&D capacity as reflected in seven Research Centers set up by the company across five countries including India, the U.S., Mexico, Brazil, and the Netherlands. Lupin’s R&D team comprises 1,400+ members.
Aurobindo Pharma, another prominent pharma company which is the largest generic pharma company in the US (by Rx dispensed as per IQVIA December 2024 data) has 9 R&D Centers including 5 in India and 4 in the USA. Aurobindo Pharma has 1,500+ scientists and analysts in the R&D team. In FY24, the company spent 37.0 per cent of its total R&D spending towards advancing the Biosimilar pipeline which are likely to be affordable as compared to high-cost Biologics. Aurobindo has been engaged in voluntary licensing agreements too, e.g., the sub-licensing agreement with the Medicines Patent Pool (MPP) to develop and market Nilotinib capsules in 44 LMICs. CuraTeQ Biologics, a wholly owned subsidiary of Aurobindo as a biopharmaceutical company focuses on developing cost-effective biosimilars for treating patients affected by life-threatening diseases.
On Product Delivery count, Indian pharma companies have performed well, e.g., products of Sun Pharma are registered in about 100 countries. Sun Pharma has registered or filed for registration at least one product in 64 LMICs. Cipla has presence in over 80 countries and has registered products including essential medicines for HIV/AIDS, TB, and Malaria. Aurobindo Pharma markets its products in over 125 countries. Through its ARV program, the company provides high-quality antiretroviral drugs to over 3 million people living with HIV in more than 125 countries.
On Equitable Access Strategies as a Priority Area under Product Delivery, Lupin has gone beyond focusing on accelerating ARV and anti-TB medicine registrations in LMICs. In South Africa, Lupin in partnership with Tutudesk Foundation (aka the Tutudesk Campaign), supported access to education, aiming to reach 20 mn children by 2025. Through its Global Institutional Business, Lupin supplies TB and HIV medications to over 50 countries across Africa, Latin America, the Commonwealth of Independent States (CIS), and Asia.
Top pharma companies hold a robust portfolio and have successfully defending their patents in various international markets. Licensing Quality has improved a lot over a period, e.g., Lupin acquired Medisol in France which enhanced its complex injectables presence in Europe. Top Indian Pharma companies lack structured Product Donation Programs even though these companies have contributed through Product Donations, e.g., Sun Pharma donated products during Sikkim flash floods, as well as during Covid. Cipla South Africa is involved in the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme (aka “dablapmeds”) under which ‘dablap’ is a colloquial term for ‘shortcut’ as a stable patient is allowed to collect chronic medication at more convenient locations instead of sitting in a queue at the clinic. In FY24 alone, the company delivered 475,000+ medicine parcels benefiting 250,000+ patients via 47 pickup points.
Major Indian pharma companies have developed Inclusive Business Models and have shown commitment to improve product availability by strengthening their local manufacturing presence. Top pharma companies are also engaged in health system strengthening through partnerships and CSR initiatives, including training healthcare workers and supporting health infrastructure.
If performance of top Indian pharma companies is observed in contrast to top MNCs then top Indian pharma companies lack in implementing comprehensive access strategies across 15 ATMI indicators. It is mainly attributed to MNCs’ long-standing global access programs, structured governance models, and measurable outcomes. Top Indian pharma companies have limited strategic integration of access principles at the governance level. Product Delivery is the strongest area across top Indian pharma companies, indicating better performance in supply chains, affordability, donations, and patient support.
Dr. Anil Kumar Angrish-Associate Professor (Finance and Accounting) and In-Charge, Department of Pharmaceutical Management, NIPER S.A.S. Nagar (Mohali), Punjab
Shrestha Saha- M.B.A. (Pharm.) (Batch: 2023-25)Department of Pharmaceutical Management, NIPER S.A.S. Nagar (Mohali), Punjab
Disclaimer: Views are personal and do not represent the views of the Institute.
