Evaluating the corporate social responsibility agenda for high-cost novel therapies: roles for government and civil society

Abstract Background Corporate social responsibility (CSR) activity in the pharmaceutical industry is frequently directed towards improving patient access to medicines amongst low-income populations. This research reports on findings from a mixed literature and key informant study of pharmaceutical sector CSR activity and its applicability in the high-cost novel therapeutics space. Methods Academic and grey literature documents were extracted from online databases in a rapid literature review, focusing on four key areas of interest: (i) CSR or benefit company activity, (ii) the pharmaceutical industry, (iii) the development and sale of high-cost novel medicines and (iv) the role of government and civil society in this space. Ten semistructured interviews amongst key informants, including medical activists, pharmaceutical industry representatives, patient advocates, employees at nongovernmental organizations (NGOs), consultants for international organizations and academic researchers were also conducted related to these topics. Results We find that CSR strategies vary depending on partner identity and country ability to pay. Differential pricing schemes and flexible patent approaches tend to be pursued unilaterally by companies, whereas companies frequently partner with local private sector, government, nongovernmental organizations and academic actors when implementing patient support programs, medicines donations, medicines delivery programs and rare and neglected disease research and development (R&D) initiatives. Patient support programs are more prevalent in high-income countries with minimal state-subsidized healthcare, whilst differential and tiered pricing strategies are more frequently pursued in lower-income countries. Conclusions Pharmaceutical CSR strategies may benefit from greater coordination with government and civil society actors. Opportunities for government and civil society actors to take an active role in better aligning CSR activity with patient needs and universal health coverage include promoting greater adoption of alternative corporate structures and providing active external recognition of successful CSR initiatives through reputational and funding awards.