Data Architecture
How We Build the Score
Six public data sources feed five analytical pillars. Pillar scores are composite-weighted then peer-adjusted — producing a single, comparable Clinical Value Score (0–100) for every covered company.
Hover any node for detail · particles show live data flow
Clinical Benefit
Translates benefit ratings into a calibrated clinical value signal per therapeutic context.
Pipeline Activity
Breadth, quality, and phase progression of each company's active development portfolio.
Capital Governance
Executive incentive alignment, capital deployment, and board composition scoring.
Burden Alignment
Overlap between a company's pipeline and highest-burden disease categories globally.
Research Integrity
First-in-class ratio, publication quality, and research-commercial separation scores.
Therapeutic Clusters
Groups companies by therapeutic focus for like-for-like peer comparisons.
All data sourced from primary public registries · scores recomputed quarterly for 676 companies
Key Findings
77%
of new medicines 2010–2019 offer no or only slight improvement over existing treatments
EbiCap analysis · PMPRB data · n=390
About
EbiCap — Pharmaceutical Value & Society
EbiCap is an independent research platform that asks one question: do pharmaceutical companies generate clinical value for society proportional to the financial capital they extract from it?
We aggregate and analyse data from global regulatory bodies, clinical trial registries, and public health institutions to produce the Therapeutic Impact (TF) Score — a multi-dimensional ranking system covering 633 publicly listed pharmaceutical companies. Every metric is derived automatically from primary public sources with no analyst subjectivity and no paid data feeds.
The question is deceptively simple: does each drug actually improve health outcomes relative to what already exists — and is its price proportionate to that benefit?
Mission
Make the relationship between pharmaceutical R&D investment, clinical benefit, and public health outcomes legible, measurable, and comparable across every major company.
Approach
Automated, reproducible pipelines built on globally recognised public health and regulatory data — rebuilt continuously, with full audit trails from source to score.
Independence
No pharma industry funding. No proprietary data access. Every number in the platform can be traced to a primary public source, ensuring complete objectivity.
Purpose
Support payers, policymakers, investors, and patient advocates in evaluating whether capital allocated to pharmaceutical R&D serves the populations most in need.
The Evidence Problem
The Evidence Problem — Publication Bias
A well-documented structural problem in pharmaceutical research is selective publication: companies run many trials but negative results are roughly twice as likely to remain unpublished as positive results — creating a systematically distorted evidence base.
The consequences reach every prescribing decision. Guideline authors, health technology assessment bodies, and physicians are working from an incomplete picture. A drug that appears effective in the published literature may have a very different benefit–risk profile when negative results are seen.
~50%
Publication bias risk
Estimated proportion of negative trial results never published
<40%
WHO mandate compliance
Proportion of clinical trials that meet the 1-year WHO publication deadline (AllTrials)
~30%
Outcome switching rate
Frequency of primary endpoint changes between registration and publication (Chan et al. 2004)
EbiCap tracks publication rates and outcome consistency for registered trials. Companies where completed trials produce no published results — or where published endpoints differ from registered endpoints — receive a reduced trial transparency sub-score in P2.
What Real Innovation Looks Like
What Real Innovation Looks Like — Le Fanu's Timeline
James Le Fanu's The Rise and Fall of Modern Medicine (1999) charted the twelve definitive advances in twentieth-century medicine — the interventions that genuinely transformed the human condition. His timeline reveals a striking pattern: genuine breakthroughs cluster in short windows; they are almost never incremental.
Breakthrough Eras (Le Fanu Framework)
Antibiotic & Steroid Revolution
Penicillin (1943), streptomycin (1947), cortisone (1948), polio vaccine (1955), chlorpromazine (1952)
Chronic Disease Era
ACE inhibitors (1981), statins (1987), H₂ blockers (1976), beta-blockers, SSRIs — diseases managed across decades
Biotech Transition
Anti-TNF biologics (rheumatoid arthritis 1998), imatinib for CML (2001), HAART for HIV (1996)
Incremental Accumulation
Predominantly me-too compounds, formulation changes, new indications for existing molecules; genuine breakthroughs rare and costly
Modern pharmaceutical companies predominantly operate in the fourth era — producing compounds that offer marginal improvements within already-crowded therapeutic classes, while pricing them as if they were transformative. EbiCap's innovation tier system traces this pattern at company level.
The QALY Standard
The QALY Standard — What Real Value Looks Like
Canada's Patented Medicine Prices Review Board (PMPRB) introduced a five-level “therapeutic improvement” scale that maps each benefit rating onto an empirically derived QALY gain per patient per year. This provides a concrete answer to the question: what does “added benefit” actually mean in terms of healthy life?
| Benefit Level | QALY Gain | Healthy Days | Typical Example |
|---|---|---|---|
| 0 — No added benefit | 0.003 | ~1 day | Incremental dose change, no clinical difference |
| 1 — Minor improvement | 0.055 | ~20 days | Modest symptomatic relief vs existing therapy |
| 2 — Moderate improvement | 0.126 | ~46 days | Meaningful reduction in disease burden |
| 3 — Substantial improvement | 0.307 | ~112 days | Major clinical advance (e.g. first TNF inhibitor 2000) |
| 4 — Major improvement / Breakthrough | 0.683 | ~249 days | First effective treatment for a serious condition |
EbiCap uses this scale as the primary unit of measurement for P1 (Clinical Benefit). The score is normalised against 0.683 QALYs — the value of a genuine breakthrough.
The Independence Standard
The Independence Standard — The Mario Negri Model
Donald Light and Antonio Maturo's Good Pharma (2015) profiles the Istituto di Ricerche Farmacologiche Mario Negri in Milan as the benchmark for what genuinely independent pharmaceutical research looks like. The Mario Negri Institute (MNI) runs trials with:
Pre-registration
All trials registered before recruitment begins, with protocol locked
Active comparator
Best existing therapy always used as comparator — never placebo alone
Clinical endpoints
Outcomes patients care about: mortality, hospitalisation, quality of life
Full publication
All results published regardless of direction — positive and negative
All-cause mortality
Primary endpoint includes all deaths, not just disease-specific deaths
Open data
Data shared with other researchers on request, with patient consent
Industry-sponsored trials routinely fall short on several dimensions. Choosing placebo comparators inflates apparent efficacy. Surrogate endpoint selection enables regulatory approval without confirming patient benefit. Selective publication hides harms. The Mario Negri benchmark makes each gap visible.
The Innovation Gap
The Innovation Gap — 4,000 Diseases, 250 Treated
Of the approximately 4,000 diseases with known causes, effective treatments exist for roughly 250. The remaining 3,750 represent an investment gap — conditions where the global disease burden is real but the commercial incentive is insufficient to attract industry capital. This gap is structural, not accidental.
~4,000
Diseases with known cause
~250
With effective treatments
~3,750
Without adequate treatments
The concentration of pharmaceutical investment in high-revenue therapeutic areas — oncology, immunology, neurology in wealthy markets — leaves conditions affecting billions of people in lower-income countries systematically neglected. EbiCap's disease burden alignment score (P4) rewards companies that actively build pipelines in high-burden, low-commercial-incentive areas.
Executive Incentive Quality
Executive Incentive Quality — VCSi Regressions
EbiCap classifies executive incentive structures across pharmaceutical companies into three regimes: VCSi (Value-Creating Science incentives) link executive pay to patient outcomes, clinical milestones or societal benefit metrics. VCShi link to softer health-science proxies. Financial-only link exclusively to TSR, EPS and revenue growth.
Crucially, the regime a company adopts is not permanent. EbiCap tracks year-by-year changes. Companies that downgrade from VCSi to weaker types — “regressions” — signal a retreat from patient-value orientation. Notable examples:
Downgraded patient-outcome triggers to softer health-science indicators
Restructured exec comp towards TSR metrics following biopharma split
First major pharma to link CEO pay to access & innovation KPIs
Embedded patient-affordability metrics into LTIP after PCSK9 pricing controversy
The Regulatory Gap
The Regulatory Gap — Health as the Missing ESG Spoke
The EU Sustainable Finance Disclosure Regulation (SFDR) and EU Taxonomy (Regulation 2019/2089) define rigorous disclosure and classification standards for environmental and social factors — including climate transition plans with science-based targets. Yet no equivalent framework exists for health outcomes as a dimension of investor accountability.
The ESG Taxonomy Gap
Environmental
Science-based targets · EU Taxonomy aligned · TCFD reporting
Social
Partial (labour rights, gender diversity); no health-output mandate
Health
No benchmark. No science-based target. No EU Taxonomy definition.
The WHO's ESG+H proposal (2022) called for the inclusion of health outcomes as a formal fourth pillar of ESG investor reporting, with mandatory disclosure of the clinical benefit delivered by investee pharmaceutical companies. PGGM's policy language — requiring portfolio companies to demonstrate therapeutic improvement over existing treatments — represents the current gold standard for investor health policy.
PGGM Responsible Investment Framework — Health Policy Approach (2021):
Portfolio pharmaceutical companies are expected to demonstrate that new products provide clinically meaningful improvement over existing treatments as assessed by an independent health technology assessment body. Companies that systematically fail this standard are subject to escalation through engagement, voting and, ultimately, divestment.
Paraphrased from PGGM Responsible Investment Policy (2021 edition). The underlying expectation — requiring evidence of added value vs. existing treatments assessed by an independent body — is documented in PGGM’s published policies.
The EbiCap Therapeutic Impact framework was built specifically to operationalise this standard at scale. A company's TF Score is a direct, evidence-based answer to the question institutional investors increasingly ask: does this company’s pipeline deliver meaningful clinical benefit over existing treatments?
Methodology
Our Research Framework
The EbiCap Therapeutic Impact framework is built on a single conviction: that the value a pharmaceutical company delivers to society can be measured objectively, without relying on self-reported metrics, marketing claims, or subjective analyst opinion.
The Five Pillars
Clinical Benefit & Access
HTA ratings from NICE, G-BA/IQWiG, HAS and PMPRB mapped onto a QALY ladder. Primary signal — what benefit do patients actually receive, relative to existing treatments, and at what cost of access?
Pipeline Quality & Innovation
Quality and composition of each company's active clinical pipeline — not size. Pipelines targeting genuine unmet needs, carrying regulatory designations evidencing meaningful improvement, score higher than expansive pipelines of incremental or copycat compounds. Trial transparency sub-score for publication rate and active comparator usage.
Capital Stewardship
How companies deploy the capital they generate — measuring the balance between reinvestment into research and extraction via shareholder payouts. Executive compensation structures for alignment with patient outcomes vs. short-term financial metrics (VCSi/VCShi taxonomy).
Disease Burden Alignment
Strategic alignment with true unmet need, measured against globally recognised GBD 2023 disease burden data. Companies targeting high-DALY, high-severity, high-unmet-need conditions score highest.
Efficiency & Governance
How efficiently research investment translates into output, with an Angell discount for companies whose approved drugs extensively cite NIH-funded public research — reducing private R&D efficiency credit when foundational science was taxpayer-funded.
Mean Field Peer-Adjustment
Pharmaceutical companies do not operate in isolation. Their compensation structures, R&D priorities, and regulatory risk profiles are correlated through shared institutional ownership and competitive pressure within therapeutic areas. A scoring model that treats each company as independent ignores this fundamental structure.
EbiCap incorporates a Mean Field Peer-Adjustment — a concept borrowed from statistical physics, where the state of each particle in a complex system is influenced by the average behaviour of all other particles (the “mean field”). Applied to pharmaceutical accountability:
Layer 1 — Therapeutic Cluster Field
Companies are assigned to one of 17 ICD-10 chapter clusters based on the plurality of their registered trial conditions (e.g. C=Oncology, G=Neurology, F=Mental Health, I=Cardiovascular). Each company's raw TF Score is normalised against its cluster's mean and standard deviation — a company scoring 2σ above its oncology peers is assessed differently than one scoring 2σ above in a smaller, weaker cluster.
Layer 2 — Ownership Network Field
Using SEC 13-F institutional holdings, we compute an AUM-weighted ownership overlap matrix. The ownership field for each company is the share-weighted mean z-score of its institutional co-owners' other portfolio companies. Being predominantly owned by funds that tolerate poor governance at peer companies represents systemic ecosystem risk — captured here.
The Result
A company 2σ above its therapeutic peers, owned by shareholder-engaged institutional funds, can receive up to +5 points post-composite. A company performing below its peer mean AND held by governance-indifferent funds across multiple low-accountability positions receives up to −5 points. The adjustment is bounded by the hyperbolic tangent function — it contextualises the score without overriding first-order pillar assessments.
For
Who Uses EbiCap
ESG & Responsible Investment
Screen pharma holdings for genuine patient-outcome orientation vs. value extraction. Verify PGGM-standard therapeutic improvement. Flag VCShi compensation before the next governance scandal. Audit SLB health KPIs.
Healthcare Hedge Funds
Access differentiated alpha signals: HTA clinical benefit vs. market pricing, first-in-class pipeline quality, institutional ownership overlap, and MFT peer-relative score deviations that precede re-rating events.
Pension Funds & SLB Issuers
Assess and monitor health-linked KPI commitments on Sustainability-Linked Bonds. Track real clinical outcome delivery against bond covenant targets using EbiCap’s independent HTA-grounded scoring.
Policy & Advocacy
Quantify the gap between R&D capital deployment and therapeutic need for cite-ready advocacy. Neglect Index, economic welfare values (Murphy & Topel), and DALY/trial count ratios — all with full source citations.
Investigative Journalists
Cross-link 12 public datasets in one query. Settlement history, physician payments, HTA rejections, patent transfers, and executive comp triggers — the data infrastructure for accountability reporting.
HTA Bodies & Payers
Benchmark company-level transparency, trial quality, and disease-burden alignment. Use EbiCap as an independent academic reference when negotiating reimbursement or coverage conditions.
Health Ministries
Inform drug reimbursement decisions with comparative data on therapeutic value, patent lifecycle, pricing disparity, and clinical pipeline quality — across the entire marketed pharmaceutical universe.
Pharma Executives
Benchmark your company against peers and the full industry on TF Score pillars. Understand where capital deployment, pipeline composition, and compensation structure compare against best-in-class and sector mean field.