Our Business, Our Purpose

Understanding the External Environment

Changing Patient Demographics

Changes in lifestyle, such as diet, urbanization and exercise habits, combined with increasing life expectancy in many countries, are leading to increased prevalence of non-communicable diseases (NCDs), such as cancer, cardiovascular disease and diabetes. Chronic diseases are often difficult to treat and create a need for pharmaceutical companies to innovate new breakthrough medicines and vaccines.

These factors are creating new challenges to help enhance and extend lives, but also increase pressure on health care providers and policymakers.

1 in 4 One in four people around the world, outside of Africa, is expected to be over the age of 60 by 2050.1

3 out of 4 Chronic diseases are expected to account for almost three out of four deaths worldwide by 2020.2

Trend Response

Our strategy is closely aligned to the United Nations Sustainable Development Goal (SDG) 3, Good Health and Well-being at all ages. A key target of this goal is to reduce by one-third the number of deaths from NCDs by 2030. We are working hard to address some of the most pressing public health challenges, both through our focused research and development activities, as well as by collaborating with civil society and global institutions that aim to provide information and novel solutions to tackle this issue.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core

Political Uncertainty

Pfizer operates globally and in a highly regulated industry. Ongoing global political uncertainty adds complexity to our ability to operate in some countries, as governments set pharmaceutical policies and regulations. In 2016 and early 2017, governments adopting nationalist agendas led to political variability in both the U.S. and Europe and, as a result, an increased lack of clarity remains in relation to legal and regulatory health care reforms.

Trend Response

Where possible, we engage with national governments, policymakers and regulatory authorities. Through this active engagement, we can better anticipate potential regulatory decisions and help position our business accordingly. We engage proactively and seek to help to inform public policy discussions in an appropriate and compliant manner.

Stakeholder Engagement

Strategy/Imperative

Be a responsible corporate citizen

Patient Empowerment

Widespread internet availability continues to transform how patients engage in their health care, from the earliest symptoms through the treatment process and beyond. This access to information helps patients become better informed about their conditions, as well as medicines available to them.

Trend Response

We are working to improve the way we engage with our patients, as well as providing them with resources and information to better take health and wellness into their own hands. This year, we launched several digital initiatives to help improve patient empowerment, details of which can be found using the links below.

Strategy/Imperative

Be a responsible corporate citizen

Pricing

Aging and changing demographic shifts have placed pressure on health care systems, and new gene therapies and cures that bring breakthroughs and value with upfront costs, are putting a strain on health care budgets. In emerging markets, the middle class has growing expectations for governments to provide quality health care and access to innovative treatments. These factors have led to an increased focus on the affordability of medicines and, as a result, some governments, payers, patient groups and other stakeholders are seeking to reduce the price of medicines through regulation and/or other means.

An investment in medicines delivers value to society in a number of critical ways: it helps avoid other costly health care interventions, increases patients’ quality of life and has demonstrated improved worker productivity. When pricing our medicines, we consider a variety of factors. We also seek to provide medicines that are reasonably affordable for patients, payers and governments, considering the value that our medications bring to those stakeholders and to the health care system.

90% In the U.S., nearly 90 percent of prescriptions dispensed are for generic medicines. The other 10 percent tend to be for more innovative medicines - many of which are for serious, hard-to-treat conditions.4 These innovative medicines are typically more expensive than generic medications, but after a limited patent life, these innovations will face generic competition and this cycle supports system financial sustainability.

Trend Response

Pfizer is committed to pricing our medicines in a way that reflects the benefit they bring to patients and society, ensuring patients have reasonable access and enabling us to continue to invest in new medicines. We may consider several factors when setting a price for a product. This may include the product’s likely impact on patients and their disease, the availability of other treatments, and the role of generic developments. This also can take into account the potential to reduce other health care costs (such as hospital stays), affordability, investments to maintain quality, safety, reliability, and our ability to continue to innovate to bring new, life-changing medicines and vaccines to patients. We also consult physicians, payers and patient groups, as appropriate.

In addition to our innovative, branded therapies, we also offer a portfolio of more than 600 generic medicines that are lower-priced alternatives for many drugs that no longer hold exclusivity.

We are continuing to broaden the transparency of our price-setting process. In 2017, for instance, we launched a series of articles on our main website, aimed at providing stakeholders with more information into how we may set the price of many of our medicines. We are also working to ensure that out-of-pocket costs, which for the insured population are determined by payers and not by Pfizer, do not become a barrier to proper utilization of our medicines.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core

Access

Barriers to health care and access to medicine are broad societal problems that cannot be resolved by pharmaceutical companies alone. However, as developers and manufacturers of medicines and vaccines, these companies have a responsibility to help facilitate access in partnership with many other stakeholders in the health ecosystem.

2bn Globally, 2 billion people do not have access to the medicine they need.5

Trend Response

Pfizer is addressing access issues on multiple fronts, leveraging our people, resources and creative commercial strategies to develop sustainable, responsible solutions. For example, Pfizer is at the forefront of developing biosimilar medicines, which could help transform the treatment of difficult-to-treat diseases by helping health care systems manage them more cost-effectively. By providing options that can be more affordable for health care systems, biosimilars can allow for the reallocation of resources to other areas of patient care, while still delivering similar quality, efficacy and safety as the originator biologic. Please see “Innovation and Data” below for details on our strategy for innovating to address unmet medical needs.

In the U.S., Pfizer RxPathways® helps connect eligible patients to assistance programs that help them get their medicines for free or at a savings. We also offer patient assistance programs that provide select Pfizer medicines for free to patients who qualify. The income eligibility for these programs start at 400 percent of the Federal Poverty Limit, meaning more patients may be eligible to receive help from Pfizer.

In 2017, we helped more than 250,000 patients receive over 1.8 million Pfizer prescriptions for free or at a savings.6

Through our various Corporate Responsibility programs and the Pfizer Foundation,7 we work with patient groups, governments, not-for-profit organizations and others around the world to provide financial donations, as well as discounts and donations of our medicines, helping to bring life-changing treatments to individuals who may not otherwise have been able to afford or have access to them.

We are working to help broaden access to Pfizer's long-acting injectable contraceptive, Sayana® Press (medroxyprogesterone acetate), for women most in need in some of the world’s poorest countries. This work is done through a collaboration with the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation.

And, through our partnership with Gavi, the Vaccine Alliance, we provide Prevenar 13® (Pneumococcal 13-valent Conjugate Vaccine [Diphtheria CRM197 Protein]) to infants and children through Gavi’s Advance Market Commitment (AMC). To demonstrate our support of the AMC, we have committed to supply up to 740 million doses of this critical pneumococcal vaccine at our lowest global price through 2025.

Pfizer does not support anti-competitive behavior that blocks patients’ access to the medicines they need, and initiates litigation where we believe that other companies are doing so to the detriment of patients.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core

Innovation and Data

As we continue to effectively treat and manage chronic and life-threatening diseases, pharmaceutical companies must continue to advance innovative medicines and vaccines. In recent years, developments such as biologics and precision medicine have been effective at treating many of these diseases.

Technology is changing the way we approach our research and development activities. Mobile and internet connectivity, “big data” and analytics bring new insights and huge opportunity to drive innovation. Data will help scientists to more efficiently develop medicines and better define which patients will benefit most from specific treatments and vaccines.

$200bn Analytics can reduce health care expenditures by $200 billion in the U.S. alone by the end of the decade. 8

Trend Response

The development of novel approaches to treat and prevent disease is an integral pillar of our strategy (Innovate and Lead) and is a core focus of our research and development activities. In 2017, we invested $7.7 billion into researching and developing new treatments.

We also recognize that, sometimes, the key to innovation is through teamwork. At Pfizer, we not only collaborate with academia and patient organizations to share expertise in a common area, but also work with other companies to potentially accelerate new innovations and therapies.

We use data at all stages of the research and development process to help discover potential medicines, assess efficacy in clinical trials and help ensure manufacturing and supply chain excellence.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core, Make capital allocation decisions that maximize patient benefit and enhances shareholder value

Competition from Generics

A generic drug is loosely defined as a pharmaceutical medicine that is equivalent to a brand-name product in dosage, strength, route of administration, quality, performance and intended use. Generic medicines tend to cost less than brand-name drugs because they don’t have the investment costs to develop a new drug. On average, a small-molecule generic medicine takes only about two years to develop, at a cost of around $1 million to $2 million dollars (versus 10 years and $2.6 billion dollars for a new medicine).4 After a product loses market exclusivity, other companies can legally manufacture and sell a generic alternative at a lower price.

Patents and other forms of intellectual property (IP) play an important role in incentivizing the discovery and development of newer and more effective medicines and vaccines that address unmet medical needs of patients. Patent-protected medicines are the necessary precursor of generic medicines – put simply, the generic medicines of today are the innovative medicines of yesterday that have since come off-patent. Big picture – by paving the way for generics, a continuous cycle of innovation, incentivized by patents, helps lower health care costs and makes certain medicines more accessible to patients over time.

<0.1% The average cost to produce a generic medicine is less than 0.1 percent of the cost to produce the original.9

Trend Response

Pfizer is focused on harnessing the full power of science to develop a comprehensive portfolio of medicines and vaccines that transform the lives of patients around the world. This purpose drives our desire to provide access to medicines for patients that are safe, effective and affordable.

Through our Pfizer Essential Health (PEH) and Pfizer Innovative Health (PIH) businesses, we have the capability to both develop innovative medicines and vaccines with appropriate patent protection, as well as high-quality generics.

To help ensure that our business remains viable, we actively evaluate our business strategy in all markets to help ensure continued innovation and access. Strong IP protections give companies like Pfizer confidence that their resource-intensive research and development efforts will be protected, thus enabling companies to potentially launch new medicines faster and facilitate access for patients globally.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core, Make capital allocation decisions that maximize patient benefit and enhances shareholder value

Trust and Expectations

A period of sustained low economic growth and a series of high-profile corporate crises have contributed to a global breakdown in society’s trust for “big business.” Generally, there are increasing expectations of the role that companies should play in society.

Specifically, within the pharmaceutical industry, recent media attention and investigations into the safety and pricing practices of a few companies have magnified this issue, leading to a reputational challenge across the entire industry.

Trend Response

Being a responsible corporate citizen has long been a part of Pfizer’s heritage, and our OWNIT! culture inspires colleagues to be strategic, passionate and courageous at work, every day, to impact our business and, ultimately, the patients we serve. Using straight talk, performing with integrity, fostering a sense of personal accountability and exhibiting leadership at every level of the organization are some of the ways we demonstrate and earn trust. We are committed to the highest levels of quality, compliance and performing with integrity, and we care deeply about the patients who need our products and the communities in which we work and live.

We embody these commitments every day in all that we do. Examples:

  • In 2017, we launched an innovative partnership called Access Accelerated that brings together 23 pharmaceutical companies, the World Bank and the Union for International Cancer Control to address the growing burden of non-communicable diseases in low- and lower-middle-income countries.
  • To help patients in the U.S. get the medicines they need, we continue to evolve our assistance programs. This past year, we launched our first-ever direct-to-consumer digital ad to help patients and caregivers who might be eligible for assistance better understand our programs and how to access them.
  • We are always trying to improve the understanding of our mission to develop and deliver quality medicines and to be transparent in our business practices. We launched a digital campaign featuring our scientists and manufacturing colleagues to illustrate our commitment. We have information about how we price our medicines on Pfizer.com, highlighting how we strive to maintain a balance between value to patients and society with our ability to invest in ongoing research and development of future medicines. (See Pricing and Access).

Pfizer is proud to be a leader in finding solutions to help ensure that health systems are affordable and sustainable and, thus, we have a broad set of initiatives with external partners to address some of the most vexing problems.

  • We are working with others across the health care sector to develop new approaches to encourage use of preventive therapies in the belief that this will help reduce overall health care spending. This includes raising awareness about the benefits of vaccines, smoking cessation and adherence to medicines that manage and mitigate health conditions.
  • We continue to partner with leading health care economists to examine the impact that out-of-pocket costs can have on patient medication adherence, overall health care spending and patient outcomes so that we can work with payers to make more informed decisions about how to design health care benefits that truly protect people’s health.
  • We have developed policies that govern the way our employees carry out our activities, to make sure we conduct our business in a safe, ethical and transparent manner. Please see Governance & Ethics for more information.
  • Pfizer is engaged to help combat the U.S. opioid crisis. In 2017, we committed to donating up to 1 million doses of Naloxone Hydrochloride Injection, USP to Direct Relief over four years (up to 250,000 doses per year), and $1 million in opioid overdose grants to five states (Illinois, Massachusetts, New Mexico, New York and Tennessee). We also are developing a non-opioid drug, tanezumab, for osteoarthritis, chronic low back pain and cancer pain in partnership with Eli Lilly. In June, the U.S. Food and Drug Administration granted Fast Track designation for tanezumab for the osteoarthritis and chronic low back pain indications. If approved, this will be the first in a new class of non-opioid pain medications.10 Regular stakeholder engagement and partnerships inform our global and local decision making. Please see Stakeholder Engagement for more information.

Strategy/Imperative

Be a responsible corporate citizen

Antimicrobial Resistance

Antimicrobial resistance (AMR) is a leading global public health threat and a major challenge for health care systems. Alarmingly, antimicrobial medicines are losing their effectiveness, because pathogens change and find ways to resist the effects of antibiotics. The pathogens survive, grow and spread their resistance; this process of adaptation leads to AMR. Overuse and misuse of these treatments is accelerating the process of resistance, as AMR can affect anyone, of any age, in any country.

Without effective antimicrobials, even routine medical procedures can become high-risk. Once a microorganism has become resistant, there are a limited number of remaining treatment options, which represents a significant public health and economic burden to health care systems.

3.8 percentAccording to the World Bank, drug resistant infections could reduce world GDP by 2-3.8 percent by 2050. 11

700,000 Deaths per year attributed to AMR globally could increase to 10 million predicted by 2050. 12

Trend Response

Pfizer is working closely with the infectious disease community to raise awareness of this serious global health threat and to help identify innovative solutions to help combat AMR and help ensure antibiotics are prescribed appropriately and for the right duration. This year, we progressed well against the AMR roadmap commitments that we released in 2016, alongside 12 industry partners, to reduce the rising incidence of AMR by 2020. We’ve worked hard to put this commitment into action by advancing active stewardship, surveillance and good manufacturing practices, supporting global policy leadership and expanding our diverse portfolio of more than 80 anti-infectives. These efforts have been recognized by both the AMR Industry Alliance in their recent progress report, as well as by the Access to Medicines Foundation in their first AMR Benchmark Report, where Pfizer is cited “among the top performing large research-based pharmaceutical companies,” in large part due to the work we do on stewardship, access, and responsible manufacturing. Please see Anti-Infectives and Environment, Health & Safety for more information.

Experts agree that vaccines, too, play a vital role in the arsenal to address AMR and Pfizer is committed to continuing the development of new, innovative vaccines and providing access to existing vaccines to help prevent serious disease globally.

Strategy/Imperative

Be a responsible corporate citizen, Ensure a productive, industry-leading innovative core

References

1. World Population Prospects The 2017 Revision, United Nations
https://esa.un.org/unpd/wpp/Publications/Files/WPP2017_KeyFindings.pdf

2. Nutrition Background, World Health Organization
http://www.who.int/nutrition/topics/2_background/en/

3. Let’s See How Biosimilars are Developed, Pfizer Inc.
https://www.pfizerbiosimilars.com/biosimilars-development

4. Why are Some Medicines So Expensive Today?, Pfizer Inc.
https://www.pfizer.com/news/featured_stories/featured_stories_detail/why_are_some_medicines_so_expensive_today

5. Access to Medicines Index, Access to Medicines Foundation
https://accesstomedicineindex.org/about-the-index/

6. Data on file. Pfizer Inc., New York, NY

7. The Pfizer Foundation is a charitable organization established by Pfizer Inc. It is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

8. Analytics in the Pharmaceutical industry, Innoplexus
https://www.innoplexus.com/2017/03/02/analytics-pharmaceutical-industry/

9. Pfizer Policy Position on Antimicrobial Resistance, Global Policy & International Public Affairs, Pfizer Inc.
https://www.pfizer.com/files/about/Policy-Position-on-Antimicrobial-Resistance-8-17-17.pdf

10. Direct Relief is a humanitarian organization, operating in 70 countries and in the United States, with the mission to improve the health and lives of people affected by poverty or emergencies. It is only nonprofit 501(c)(3) in U.S. licensed to distribute pharmaceuticals in all 50 states and the District of Columbia and administers all product donation programs for Pfizer.

11. The World Bank. By 2050, drug-resistant infections could cause global economic damage on par with 2008 financial crisis. September 20, 2016. Available at http://www.worldbank.org/en/news/press-release/2016/09/18/by-2050-drug-resistant-infections-could-cause-global-economic-damage-on-par-with-2008-financial-crisis

12. Tackling a crisis for the health and wealth of nations. December 2014. Available at https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf