Fair Pharma Scorecard Methodology
The Fair Pharma Scorecard evaluates the behaviour of pharmaceutical companies during the Covid-19 pandemic against a matrix of 19 criteria. These criteria were developed by translating human rights principles and international standards into concrete company behaviours.
Below is an outline of the principles and methodology upon which this evaluation is made.
Human rights principles and international standards selection
General Comment No. 14 on the right to health (article 12) in the International Covenant on Economic, Social, and Cultural Rights:
45. For the avoidance of any doubt, the Committee wishes to emphasize that it is particularly incumbent on States parties and other actors in a position to assist, to provide “international assistance and cooperation, especially economic and technical” which enable developing countries to fulfil their core and other obligations indicated in paragraphs 43 [including provision of essential medicines] and 44 [including immunization against infectious diseases and the prevention, control, and treatment of epidemic and endemic diseases] above.
General Comment No. 24 on State obligations under the International Covenant on Economic, Social and Cultural Rights in the context of business activities:
22. The Committee is particularly concerned that goods and services that are necessary for the enjoyment of basic economic, social and cultural rights may become less affordable as a result of such goods and services being provided by the private sector, or that quality may be sacrificed for the sake of increasing profits. The provision by private actors of goods and services essential for the enjoyment of Covenant rights should not lead the enjoyment of Covenant rights to be made conditional on the ability to pay, which would create new forms of socioeconomic segregation.
In addition, the UN CESCR published the following statement in relation to pharmaceutical companies’ human rights responsibilities in the context of Covid-19:
Statement on universal and equitable access to vaccines for COVID-19:
7. In line with international standards, business entities, including pharmaceutical companies, have the obligation, as a minimum, to respect Covenant rights. Thus, business entities should refrain from invoking intellectual property rights in a manner that is inconsistent with the right of every person to access a safe and effective vaccine for COVID-19 and with the obligation of States to guarantee, as expeditiously as possible, universal equitable access to vaccines for COVID-19.
These Principles further draw from The United Nations Guiding Principles on Business and Human Rights and Paul Hunt’s Human Rights Guidelines for Pharmaceutical Companies in relation to Access to Medicines (2008). Paul Hunt was the UN Special Rapporteur on the right to health from 2002-2008.
Hunt’s work was of particular value to the scorecard, as it specifically adapts human rights principles for not just business but the pharmaceutical industry in particular. It sets out specific parameters and recommendations that have been incorporated into the scorecard, including: companies should issue non-exclusive voluntary licences with a view to increasing access to medicines; companies should be as transparent as possible; companies should make particular efforts to ensure access to medicines in low- and middle-income countries and to vulnerable populations, including those living in poverty; and the companies should integrate human rights into their strategies, policies, programs and other activities.
Translating principles into scorecard criteria
We translated human rights principles and international standards into concrete company behaviours for access to medicines, particularly during a pandemic, through iterative review rounds. An initial list of good practices was developed by Pharmaceutical Accountability Foundation experts. This list was reviewed by external experts in pharmaceutical policy, intellectual property, and the political economy of pharmaceuticals and refined.
The list was then stress tested for applicability and adequacy through the evaluation of company practices on 4 vaccine and 3 therapeutics. This resulted in 18 criteria that formed the basis of our original scorecard, published in January 2021 The criteria were subdivided into four broad categories: International cooperation; transparency; equality, non-discrimination & equity; and commitments and accountability. In December 2021, an additional criteria was added: That the company agrees to license its Covid-19 medical products to other companies.
The current scorecard therefore contains 19 criteria, detailed below.
A Commitments & Accountability
C International Cooperation
E Equity, non-discrimination & Equality
A1 The company publishes a global access plan for its product
C1 The company commits to C-TAP or MPP
E1 The company makes the active ingredient available on reasonable ground. [Only for therapeutics]
T1 The company publishes its R&D costs.
A2 The company commits to comply with human rights standards in relation to product development and marketing
C2 The company commits to not enforcing the exclusive rights of Covid-19 related patents
E2 The company commits to full technology transfer to other manufacturers
T2 The company publishes its profit margin.
C3 The company supplies to, or signs agreements with, the vaccines or therapeutics pillar of the ACT Accelerator
E3 The company commits to non-profit, ‘fair’, or differential pricing
T3 The company publishes the average and/or marginal costs of production.
C4 The company agrees to license its Covid-19 medical products to other companies
E4 The company equitably distributes supplies globally. [Only applies to vaccines]
T4 The company publishes its production capacity.
E5 The company does not seek protection beyond the minimum criteria in TRIPS, or enforces TRIPS+ measures [where applicable]
T5 The company publishes the public subsidies it received during product development and/or testing.
E6 The company agrees to waive exclusive rights in regulatory test data [where applicable].
T6 The company publishes the text of licensing agreements.
T7 The company registers its clinical trials in public repositories.
Choosing candidates and calculating scores
Companies that appear in the scorecard were selected if they had either a Covid-19 vaccine or a therapeutic in phase 3 clinical trials, had obtained emergency/restricted use authorisation, or had full market authorisation in any country. This list is updated with each successive publication of the scorecard.
Data was collected through both research and interviews with target companies. To the best of our knowledge, the evidence on which the scores are based is truthful and reliable, and that can be found in the public domain.
Prior to publication, all companies were invited to provide additional information about their activities and offered the opportunity to respond to our scoring. Only 8 took the opportunity to respond, either via an email answer form or via a telephone conversation. Their substantive responses were used to confirm or supplement our findings.
Information about company behaviour was scored on a 4-point scale, as follows:
- Green: Behaviour is compliant with Fair Pharma Principles criteria
- Yellow: Behaviour is partially compliant with Fair Pharma Principles criteria
- Red: Behaviour is not compliant with Fair Pharma Principles criteria
- Grey: Not enough information to determine.
A company’s total score was calculated by assigning a numeric value to the scale (green = 1, yellow = 0.5 and red = 0), and dividing total points by the number of criteria. Each criteria is weighted equally. Criteria on which a company score was “grey” were not counted towards the total.
To aid the transparency of this assessment, a brief description of the evidence underlying each score is publicly available in each company’s scorecard.