We ranked how top 20 pharma support patient communities

What we measure, and what we don't

Patient engagement is not about writing checks. The real work is listening to patients and partnering with the organizations that represent them, so the evidence, outcomes and experiences that matter most to patients are captured and used. Funding alone doesn't make that happen.

But financial support is one of the few signals that can be compared across companies. It shows how many patient communities each company supports, and how deeply. And it's worth knowing how yours compares with peers in your therapeutic areas.

Pipeline rank is a poor guide to financial support rank

Gilead has the 15th biggest pipeline in our group. It is the 2nd biggest financial supporter of European POs. Eli Lilly runs the other way: 7th by pipeline, 14th by financial support.

Two playbooks: go wide or go deep

Takeda, AbbVie, Johnson & Johnson and Novo Nordisk go wide. They support many POs, with 20–40% less support per PO than average.

Gilead, Sanofi, Bristol Myers Squibb and Boehringer Ingelheim go deep. They support fewer POs, with 40–100% more support per PO.

Neither playbook is better. Most companies guard PO independence, and many cap their support at a share of each PO's income. A small footprint can be a deliberate choice. The real question is whether it fits your pipeline.

Per PO, Gilead's support runs three times deeper than Takeda's.

Therapeutic area explains much of the pattern. Gilead's core is HIV, home to one of Europe's oldest and best-organized patient movements. Deep support follows. Novo Nordisk works in diabetes and obesity, where nearly every country has its own national associations. Wide support follows.

So compare yourself with peers in your disease areas, not just peers of your size.

Some pipelines are outgrowing their PO footprint

There is no right number of POs per drug. POs form around diseases, not drugs. A single cancer drug can matter to dozens of them, and most work with several companies at once.

But the spread is wide. Novo Nordisk supports nine times more POs per drug than Otsuka. Seven companies support fewer POs than they have drugs in development: Otsuka, Daiichi Sankyo, Amgen, GSK, Bristol Myers Squibb, Eli Lilly and Bayer.

That isn't a failing in itself. It becomes one when the pipeline moves into diseases where a company has no relationships yet.

Financial support doesn't show everything. It misses unpaid advisory work and partnerships run from global teams. But it is the one measure that can be compared across all 20 companies.

What this means if you lead patient engagement

If footprints followed pipelines, pipeline size would predict them. It doesn't. The pattern looks more like history: the disease areas a company grew up in, and the relationships built there.

That matters because patient insight rarely reaches development decisions on its own. Advocacy teams build relationships. Clinical development teams design trials, choose endpoints and pick sites. When the two aren't connected, the patients who shape your evidence are the ones you happen to know, not the ones your next program needs.

The gap shows up in your evidence. Trials shaped by the full range of patient experience produce the outcomes assessors now look for. EU assessments value breadth too: when they select patient experts, they favor expertise that spans several countries. For orphan medicines assessed from 2028, those trials are being designed now. The gaps you have today will show up in the evidence behind your next launch.

Three questions for your next planning cycle:

• Wide or deep: did you choose your playbook, or inherit it?
• Does your PO footprint match where your pipeline is going, or where it has been?
• When your clinical teams set endpoints and pick sites, whose lived experience are they drawing on?