Gain Internal and External Insights: Solving Big Problems
Guide decision-making to inform and evaluate Eli Lilly’s global health equity strategy. The strategy will define where we play and how we measure our impact. Ensure we have the correct structure in place to deliver our key outcomes and metrics.
This competitive analysis reveals that Eli Lilly, while showing recent progress and strong momentum, currently lacks a comprehensive strategy and operations for global health equity, placing it behind its peers in performance across key areas. Novartis and GSK have emerged as leaders, with Novartis demonstrating broad geographic reach and pioneering access initiatives, and GSK maintaining a deep presence in low-income countries with aggressive affordability programs. Sanofi has shown significant progress, particularly with its launch of a nonprofit “Impact” medicines portfolio for 40 countries. Johnson & Johnson remains a strong contender with robust R&D on diseases like TB and Ebola, coupled with large-scale donation programs. Novo Nordisk excels in the diabetes space, supplying a significant portion of the world’s insulin and implementing price caps in numerous countries. Roche, too, has improved its position by expanding product registration in developing markets and leveraging its diagnostics division.
Eli Lilly’s global health equity strategy is anchored by its ambitious 30x30 initiative, which aims to improve access to quality health care for 30 million people in resource-limited settings each year by 2030. This bold commitment, focused largely on noncommunicable diseases (NCDs), differentiates Lilly from peers who often target communicable diseases or specific regions through their access programs. Lilly has made notable progress recently with initiatives such as transferring insulin manufacturing technology to local partners, capping U.S. insulin costs, and collaborating with UNICEF on NCD care, further demonstrating a renewed commitment to global health equity. To further accelerate progress, Lilly should focus on scaling up these and other successful programs, broadening access across its portfolio, and adopting best practices from its peers. This includes implementing global tiered pricing, investing in frontline health worker training, integrating access plans into R&D, leveraging digital health tools, and enhancing transparency in reporting. By embracing these strategies, Lilly can significantly enhance its impact and solidify its position as a leader in global health equity.
Overall, Lilly’s 30x30 provides a strong foundation and clear public target that few peers match directly, but achieving its goals will require accelerating efforts and addressing areas where peers have been more active. Our analysis seeks to compare Lilly with each peer across eight categories: Geographic Reach, Access and Affordability, Health Systems Strengthening, R&D, Innovation in Digital Health and Business Models, ATMI, Public Commitment and Transparency, and Measurable Impact. We highlight where peers excel and how Lilly can apply these lessons to improve its performance and impact.
Strategy & Governance: Despite momentum, Lilly lacks a comprehensive global health equity strategy with robust governance compared to industry leaders. Peers like GSK have established governance for access and integrated access-related metrics into executive compensation.
Geographic Reach: Lilly has limited presence in LMICs versus GSK and Novartis, who maintain extensive distribution networks and local manufacturing in sub-Saharan Africa and Asia.
Access and Affordability: Despite progress in insulin affordability, Lilly trails behind GSK's comprehensive tiered pricing, Novartis's no-profit medicine portfolios, and Sanofi's Impact program covering 30 essential medicines in 40 countries.
Health Systems Strengthening: Lilly is actively strengthening health systems, particularly for NCDs, but efforts remain smaller in scale compared to industry leaders’ large scale initiatives. Leaders have made deep investments in healthcare infrastructure, supply chain resilience, and workforce education, such as Novartis’s Healthy Family program
R&D: Lilly's NCD-focused pipeline lags behind GSK's £1 billion commitment to priority diseases affecting LMICs and Novartis's collaborations with DNDi for neglected diseases.
Innovation: Lilly is expanding digital health solutions like mobile technology and AI-risk scoring but trails Roche's diagnostic infrastructure investments and Novartis's integrated digital platforms in LMICs, with limited integration into access programs.
Access to Medicine Index: Expanding initiatives in access strategies, voluntary licensing and geographic reach could improve Lilly's standing in the ATMI and enhance its impact on global health equity.
Public Commitment: Lilly's 30x30 and other initiatives demonstrate a clear commitment to health equity, but the company needs to enhance communication of long-term strategy, framework alignment and data disclosure to compete with industry leaders.
Measurable Impact: While Lilly emphasizes impact primarily through 30x30, storytelling falls short in demonstrating enterprise-wide value and long-term impact. Developing clear metrics and consistent evaluation plans, similar to J&J's workforce development metrics, would significantly improve Lilly's ability to showcase tangible impact
GSK – Clear & Highly Scaled Strategy
Strategy: GSK leads in scale-driven impact, particularly through vaccines and infectious disease programs. It works extensively with global partners like Gavi, WHO, and UNICEF to expand vaccine and HIV medicine access in LMICs.
Effectiveness: Strong and well-structured, with a clear methodology for tracking patient reach (e.g., vaccine dose-to-patient conversions). While already impactful (~89M patients in 2023), GSK is still refining how it reports broader access initiatives (e.g., deworming, which could see this number go even higher.
Verdict: Leader in structured and large-scale access programs.
Johnson & Johnson – High Reach but Focused on Donation
Strategy: J&J’s approach is rooted in donations and health system strengthening, particularly in neglected tropical diseases. Its largest initiative, the intestinal worm treatment donation program, dominates its reach (~100M patients in 2023).
Effectiveness: While high in volume, its strategy appears to rely heavily on one major program, and broader access efforts (e.g., oncology, eye health) are less transparent.
Verdict: Strong but concentrated impact; lacks broad strategic clarity.
Novartis – Diversified Access Model with Strong Commercial Tie-in
Strategy: Novartis balances a commercial plus access model, using branded generics, patient assistance, and targeted affordability initiatives in LMICs. It has a flagship Global Health Unit (not branded) to drive affordability and availability.
Effectiveness: Clearly structured and well-integrated with the business. Reports high total reach of ~800m patients, with ~40m served through access approaches in LMICs.
Verdict: One of the strongest in clarity and business alignment.
Novo Nordisk – Focused and Expanding Access to Insulin
Strategy: Novo Nordisk is laser-focused on diabetes care, with structured affordability programs like the Access to Insulin Commitment ($3 insulin pricing in 77 LMICs). It also has targeted programs like Changing Diabetes in Children.
Effectiveness: Highly focused and growing (6.7M access patients in 2023, up from ~5.5M in 2022). Novo Nordisk is now integrating broader affordability mechanisms, making its strategy increasingly clear and impactful.
Verdict: A leader in disease-specific equity but narrower in scope.
Sanofi – Emerging with a Structured Approach
Strategy: Sanofi launched the Global Health Unit (GHU) in 2021, targeting chronic disease access in 40 low-income countries with a not-for-profit pricing model for essential medicines.
Effectiveness: Still in early stages but growing fast (586K patients in 2023, targeting 2M by 2030). Sanofi’s equity strategy is becoming clearer but needs scale to match leaders like GSK and Novartis.
Verdict: Well-defined strategy, but still building momentum.
Roche – Specialty-Focused & Measured Approach
Strategy: Roche is highly specialized, concentrating on cancer care and diagnostics access in LMICs. Its City Cancer Challenge and Global Access Program provide targeted affordability mechanisms.
Effectiveness: Small but targeted impact (40,500 patients reached in LMICs in 2023). Roche’s approach is clear but niche, focused on high-cost specialty drugs rather than broad access.
Verdict: Focused but limited in scale compared to competitors.