JUST CapitalBeta
Offers fair pricing
Customers
Owners voting their values can deliver most of the outcome.
Why shareholder democracy is pivotal
A price is set by the company that charges it, so whether goods and services are offered at a fair price is decided inside the seller and almost nowhere else, which puts this at the top of the scale. The ranking introduced this issue to capture unfair pricing of the everyday kind, price gouging, shrinkflation and excessive price increases, each of which is one company's act and each of which one company can stop on its own. Eli Lilly showed the move in the other direction in a single announcement on 1 March 2023, cutting the list price of Humalog and Humulin by 70 percent, dropping its non-branded insulin lispro to 25 dollars a vial, launching Rezvoglar at a 78 percent discount to Lantus and capping what commercially insured patients pay out of pocket at 35 dollars a month. That decision had a policy background, and the record now carries it: the company tied the immediate cap to patients outside the new Medicare Part D cap, and KFF records that the removal of the Medicaid drug rebate cap gave insulin makers a direct financial reason to cut list prices, with Lilly expected to pay 430 million dollars in additional Medicaid rebates in 2024. A policy that changes what a price costs a company is not a bar on the company choosing, and Lilly chose. The lobbying against the public route to lower prices is heavy and it is the secondary story here. Public Citizen counted 545 lobbyist and client relationships working in the first three quarters of 2025 on three bills to gut Medicare drug price negotiation, with supporters of those bills outnumbering opponents twenty to one, and one of the three, the ORPHAN Cures Act, was enacted in July 2025. The programme itself survived and is operating, with negotiated prices for the first ten drugs from January 2026, fifteen more from January 2027 and every manufacturer in the third cycle signed up for 2028. Elsewhere the industry has won outright: the generic manufacturers' trade association, backed by the U.S. Chamber of Commerce, got Maryland's price gouging statute struck down in 2018, and a life sciences trade association's lawsuit helped stop Medicare's Most Favored Nation payment model before it ever operated. Investors have been working the other lever, with members of the Interfaith Center on Corporate Responsibility filing at AbbVie, Eli Lilly, Gilead, Johnson and Johnson, Merck and Pfizer on how patent extension strategies affect who can afford a medicine, though only two of those six reached a ballot in 2024, drawing 24.7 percent at AbbVie and 8.8 percent at Lilly. The lobbying narrows and delays the public route, and the price on the shelf is still the company's to set, which is why owner pressure reaches this outcome at full strength.
How this was scoredPivotal
Pivotal. Owners voting their values can deliver most of the outcome.
We have not yet written down the two answers behind this rating. Recording them on every item, so a reader can check the reasoning and not only the conclusion, is work in progress.
Every rating is the higher of two answers, one for what companies do and one for what they spend to stop the outcome, because the same vote reaches both. See the full method.
Sources
- JUST Capital 2025 Ranking Methodology (as of February 3, 2025), JUST Capital
- Lilly Cuts Insulin Prices by 70% and Caps Patient Insulin Out-of-Pocket Costs at $35 Per Month, Eli Lilly and Company via PR Newswire
- What Are the Implications of the Recent Elimination of the Medicaid Prescription Drug Rebate Cap?, KFF
- Medicare Drug Price Negotiation Program: Selected Drugs and Negotiated Prices, Centers for Medicare and Medicaid Services
- Hundreds of Lobbyists Hired to Undermine Drug Price Negotiations, Public Citizen
- Association for Accessible Medicines v. Frosh, No. 17-2166, United States Court of Appeals for the Fourth Circuit
- Most Favored Nation (MFN) Model, final rule rescinding the interim final rule, 86 FR 73986, Centers for Medicare and Medicaid Services, Federal Register
- 2024 Shareholder Proposals at Pharma Companies Cite Strategies to Keep Drug Prices High as Potential Human Rights Risks, Interfaith Center on Corporate Responsibility
- AbbVie Inc. Form 8-K/A, 2024 annual meeting voting results, AbbVie Inc., filed with the U.S. Securities and Exchange Commission
- Eli Lilly and Company Form 8-K, 2024 annual meeting voting results, Eli Lilly and Company, filed with the U.S. Securities and Exchange Commission
- Gilead Sciences, Inc. Form 8-K, 2024 annual meeting voting results, Gilead Sciences, Inc., filed with the U.S. Securities and Exchange Commission
- Johnson & Johnson Form 8-K, 2024 annual meeting voting results, Johnson & Johnson, filed with the U.S. Securities and Exchange Commission
- Merck & Co., Inc. Form 8-K, 2024 annual meeting voting results, Merck & Co., Inc., filed with the U.S. Securities and Exchange Commission
- Pfizer Inc. Form 8-K, 2024 annual meeting voting results, Pfizer Inc., filed with the U.S. Securities and Exchange Commission
What civil society organizations are helping owners on this
Coordinates member proposals at pharmaceutical companies asking boards to weigh how patent extension strategies affect patients' access to medicines, and earlier proposals on pricing of publicly funded COVID-19 products.
Filed a 2021 proposal at Johnson & Johnson asking for disclosure of how public funding for COVID-19 products would be taken into account in pricing and access decisions.
10 campaigns on record
Set up and report on a process for weighing how stretching out patent protection affects patients' ability to get medicines, before applying for follow-on patents.
Result: Filed in December 2023 for the spring 2024 annual meetings. We found no record of the vote tallies in the sources we could retrieve.
we found no documented change
Set up and report on a process for weighing how stretching out patent protection affects patients' ability to get medicines, before applying for follow-on patents.
With Mercy Investment Services
Result: Filed in December 2023 for the spring 2024 annual meeting. We found no record of the vote tally in the sources we could retrieve.
we found no documented change
Set up and report on a process for weighing how stretching out patent protection affects patients' ability to get medicines, before applying for follow-on patents.
With T1International
Result: Filed in December 2023 for the spring 2024 annual meeting. We found no record of the vote tally in the sources we could retrieve.
we found no documented change
Issue reports on how patent thickets and extended exclusivities affect patients' access to medicines; at Eli Lilly, also disclose how lobbying facilitates or impedes equitable access.
Result: not stated in source
Establish a process to evaluate how extended patent exclusivities affect product access when deciding whether to seek secondary and tertiary patents, and report the findings publicly.
Result: 30.20 percent
Patents and Access (Pfizer 2023 resolution), Interfaith Center on Corporate Responsibility, 2023
Proposals asked companies to examine whether stacking secondary and tertiary patents on existing drugs (a strategy investors said AbbVie used to extend Humira's exclusivity to 19 years through 130 patents and 27 price increases) was limiting patient access, to align lobbying with stated access commitments, and, at Moderna and Pfizer, to study transferring vaccine-manufacturing know-how so generic versions could be made.
Result: Sixteen proposals were originally filed; twelve survived company challenges at the SEC and went to a vote. Two proposals at Amgen were withdrawn after the company reached an agreement with the filers; two other proposals, at Pfizer and Moderna, were also withdrawn.
Amgen's agreement with the filers led those two proposals to be withdrawn rather than voted on; the source describing this did not specify what Amgen committed to do, and we found no further documentation of that commitment.
Resolutions asked Moderna and Pfizer to study transferring COVID-19 vaccine technology and manufacturing know-how to lower-income regions and to share technical knowledge with the World Health Organization, and asked Johnson & Johnson to explain how public research funding had affected its pricing and what it meant by distributing vaccine on a 'nonprofit' basis.
With People's Vaccine Alliance
Result: This source does not report the vote outcome for the 2022 annual meetings.
Moderna agreed to sell 500 million vaccine doses to COVAX and 110 million to the African Union and committed not to enforce its patents during the pandemic, which Oxfam called insufficient; Pfizer partnered with South Africa's Biovac for fill-finish production, though Biovac could not produce the active vaccine ingredient itself; Johnson & Johnson's nonprofit-basis distribution remained limited to emergency pandemic use with details Oxfam said were still unclear.
Report on whether and how receipt of public funding for COVID-19 vaccines and treatments is taken into account in decisions affecting access, such as setting prices.
Result: not stated in source
Pfizer and Johnson & Johnson sought SEC permission to exclude the proposals as ordinary business; the SEC allowed the proposals to proceed to votes in April and May 2021.
The resolution asked AbbVie's compensation committee to report each year on whether executives were being rewarded, through incentive pay, for pricing strategies that drew public criticism over drug costs.
Result: The proposal won 21 percent shareholder support. AbbVie had asked the SEC to exclude it from the proxy ballot; that challenge failed, and proxy advisor ISS recommended shareholders vote in favor.
We found no documented follow-up report or compensation-policy change that AbbVie made as a result of this specific vote in the sources reviewed.
Shareholders asked each company to publish a report showing how much it had raised prices on its top-selling brand-name drugs from 2010 through 2016, explain the reasoning behind those increases, and assess the legislative, reputational, and financial risk of its pricing strategy.
Result: All ten companies filed petitions with the SEC to exclude the proposals from their proxy ballots (a 'no-action' request), so none of the resolutions ever reached a shareholder vote.
We found no documented change in drug-pricing disclosure practice that resulted from this specific 2016-2017 round of proposals; the resolutions were blocked before a vote could occur.
Interfaith investor coalition pushes shareholder resolutions on drug prices, STAT News
Related subjects on other maps
How this rating was made
Every item on every one of our maps is read against one question: how far does this depend on the people who own companies voting their values? We answer it twice, once for what companies do and once for what they spend to stop the outcome, and take whichever answer is higher, since the same vote reaches both. The score carries its reasoning and its sources so that a reader can check it rather than take it.
- Pivotal. Owners voting their values can deliver most of the outcome.
- Necessary. Owners remove an obstacle nothing else removes, and others must also act.
- Helpful. Owners voting their values help, and others carry most of it.
- Independent. This moves without owners. Other levers carry it.
The advocacy record on this page holds only what a source we opened says happened. Where we searched and found nothing, the page says so rather than leaving a silence. Where a campaign names a filer the source does not name, it says that too. Ratings are ours; the list of subjects is JUST Capital's, and we link to their original.
How we score dependency, in full.