Environmental, social, and governance considerations have moved from peripheral reporting obligation to strategic priority for major pharmaceutical companies. The pharmaceutical industry faces a distinctive ESG challenge: its core social purpose can appear directly contradicted by pricing practices that limit access to those medicines in lower-income countries. The Access to Medicine Foundation’s biennial index creates public accountability that boards and ESG-focused investors use in executive compensation and investment decisions. The ten leading companies collectively announced major sustainability commitments including science-based targets for net zero and expanded access to medicines programs.
Topics Covered
• Access to Medicines
• Carbon Footprint and Net Zero
• Ethical Supply Chain
• Clinical Trial Diversity
• Drug Pricing Ethics
• Governance and Transparency
Table of Contents
1. Executive Summary
2. Landscape Overview
3. Access to Medicines
4. Carbon Footprint and Net Zero
5. Ethical Supply Chain
6. Clinical Trial Diversity
7. Drug Pricing Ethics
8. Governance and Transparency
9. Strategic Conclusions and Recommendations
10. Appendix
List of Tables
Table 1. Overview and Key Data 2025
Table 2-8. Topic-Specific Analysis Tables
Table 2. Leading Companies — Strategy Assessment 2025
Table 3. Key Risks and Mitigation Strategies
Companies Profiled
Pfizer
Johnson & Johnson
Roche
Novartis
Merck
AstraZeneca
Bristol-Myers Squibb
AbbVie
Eli Lilly
Sanofi
