Updated

European drugmakers still outrank their U.S. counterparts in making medicines available to poor people, but the lead they established two years ago is starting to shrink, according an analysis published on Monday.

The Access to Medicines Index (AMI) — released this week for the second time since its launch in 2008 — is produced by a Dutch-based foundation and backed by 22 institutional investors and fund managers, who together manage $3.1 trillion in assets.

It put Britain's GlaxoSmithKline at the top of its list of 20 of the world's largest pharmaceutical companies, ranked on the efforts to make sure medicines are made for, and reach, people in developing countries.

The index is designed to offer investors a way to compare drugmakers' social responsibility records.

Behind GSK, which lead the field in improving access to drugs and vaccines, came the U.S. drugs giant Merck & Co., Switzerland's Novartis, U.S.-based Gilead Sciences, and France's Sanofi-Aventis.

In the 2010 index, six of the ten highest-ranking companies are based in Europe, while four are based in the U.S. This compares with two years ago, when seven European and three U.S. firms got a top 10 ranking. The analysis found big differences between the world's largest pharmaceutical companies in their efforts to provide millions of people in low-income countries with affordable drugs and vaccines.

But compared to 2008, when the first index was published, drug companies gave more insight into their policies and actions to increase poor people's access to medicines, AMI researchers said in a report.

"The Index 2010 reveals important progress, if only because companies have shown far greater willingness to open up," said Wim Leereveld, the index's founder.

He said AMI's analysis had found "great improvements," especially in the areas of research and development, and equitable pricing, but added: "At the same time, it shows that the industry as a whole still has a long way to go.

"Carissa Etienne of the World Health Organization, said the index would serve as an "important tool in improving performance" in the industry.

Fund managers supporting the foundation's work include Trillium, AMP, F&C, Aviva, Sarasin, Henderson and Schroders.

The full ranking is as follows:

1. GlaxoSmithKline PLC

2. Merck & Co Inc

3. Novartis AG

4. Gilead Sciences

5. Sanofi-Aventis

6. Roche

7. AstraZeneca PLC

8. Novo Nordisk

9. Johnson & Johnson

10. Abbott Laboratories Ltd

11. Pfizer Inc

12. Boehringer Ingelheim

13. Eli Lilly

14. Bayer AG

15. Bristol-Myers Squibb

16. Eisai Co

17. Merck KGaA AG

18. Takeda Pharmaceuticals

19. Astellas Pharma Inc

20. Daiichi Sanyko Co Ltd