The Most Ethical Healthcare Companies in 2026
Pfizer more than doubled Paxlovid's price to $1,390 per course during the pandemic. UnitedHealth's Change Healthcare cyberattack exposed the medical data of 190 million individuals -- the largest known theft of medical records in U.S. history. Johnson & Johnson faces over $1 billion in ethics-related penalties in three years, including a $700 million talc settlement.
These are three of the seven largest healthcare companies analysed below. Mashinii scores over 6,000 public companies across 11 ethical dimensions using independent evidence -- penalty records, regulatory actions, verified reporting, and third-party audits. We applied that methodology to seven major healthcare and pharmaceutical companies to see what separates the top-ranked from the bottom.
Healthcare Ethics Rankings: 7 Companies Scored
The table below focuses on the dimensions most relevant to healthcare.
| Rank | Company | Better Health | Integrity | Workers | Climate | Data & Tech |
|---|---|---|---|---|---|---|
| 1 | Merck | +30 | 0 | +30 | -30 | +20 |
| 2 | GSK | +20 | -40 | +40 | -40 | 0 |
| 3 | AbbVie | +10 | 0 | +20 | -30 | -20 |
| 4 | AstraZeneca | 0 | -30 | -10 | 0 | -50 |
| 5 | UnitedHealth | 0 | -10 | +40 | -50 | -80 |
| 6 | Johnson & Johnson | -40 | -20 | +20 | +10 | +10 |
| 7 | Pfizer | -60 | -60 | +10 | -40 | 0 |
Scores range from -100 (worst) to +100 (best). Bold indicates notably strong or weak scores.
Johnson & Johnson, a company synonymous with healthcare, scores -40 on the health dimension. Pfizer sits last at -60 on both health and integrity. Merck leads on health access and is the only company with a positive data and technology score.
Merck: The Access and Transparency Leader
Merck earns the highest Better Health for All score among major pharma companies. Its products address 83% of the top 20 global burdens of disease. It signed voluntary licence agreements enabling generic COVID-19 medicines in over 100 low- and middle-income countries and provides HPV vaccines to Gavi at access prices.
Merck's clinical trial record is documented: all trials registered since 2007, all results disclosed regardless of outcome. Its Project ECHO programme has trained over 33,000 local health workers, reaching an estimated 11 million people in underserved communities. Its partners trained an estimated 349,000 healthcare workers in 2023.
On Honest & Fair Business (0), a $572.5 million Zetia antitrust charge is part of the record, but over 99% of employees completed ethics training and the company ranked No. 1 on Newsweek's Most Responsible Companies for 2025. On Fair Pay & Worker Respect (+30), Merck achieved over 99% pay equity worldwide across more than 65,000 employees. Its +20 on Safe & Smart Tech is also notable: Merck was the first healthcare company certified under the APEC Cross Border Privacy Rules and has a dedicated Code of Digital Ethics with an external advisory panel for AI governance.
View Merck's full score breakdown
GSK: Vaccine Access and Worker Treatment Leader
GSK scores +20 on Better Health for All, supported by its portfolio of vaccines -- including the RTS,S malaria vaccine and Arexvy RSV vaccine -- and licensing agreements that expand access in lower-income countries.
GSK scores the highest in this analysis on worker treatment at +40 on Fair Pay & Worker Respect. The CEO-to-median employee pay ratio was 123:1 in 2024. The company achieved a reportable injury rate of 0.42 per 200,000 hours worked with zero fatalities. Women's median hourly pay was 4.4% higher than men's in 2024.
GSK's integrity score of -40 reflects a $20 million SEC civil penalty for FCPA violations involving improper inducements to healthcare professionals in China, with similar conduct noted in other countries. On Kind to Animals (-70) -- the lowest of any company in this analysis -- GSK reported 148,766 animal uses in 2023, including rodents, rabbits, pigs, dogs, poultry, fish, and non-human primates. The No War, No Weapons dimension is a contrast at +20, with the company's conflict minerals compliance programme confirming no 3TGs in its products originated from conflict-affected countries.
View GSK's full score breakdown
AbbVie: Patient Assistance vs Billion-Dollar Penalties
AbbVie scores +10 on Better Health for All. Its products treat over 75 conditions, it invested $10.8 billion in R&D in 2024 (19.88% of revenue), and patient assistance programmes provided free medicines to over 235,000 U.S. patients. The company donates medicines to 63 low- and middle-income countries.
Against that record: AbbVie has incurred over $5.39 billion in penalties for off-label promotion and over $1.6 billion for price-fixing, according to regulatory records. Its integrity score sits at 0 after recent fines including a $4.625 million price-fixing penalty in 2025 and a $2.7 million kickback settlement in 2023. A May 2024 data breach affecting tens of thousands of consumers brought its tech score to -20.
On Fair Pay & Worker Respect (+20), AbbVie's CEO-to-median employee pay ratio was 138:1 in 2024, with a recordable incident rate of 0.13 per 200,000 hours worked and zero fatalities. Approximately 25% of employees are covered by collective bargaining agreements.
View AbbVie's full score breakdown
AstraZeneca: Reach Without Transparency
AstraZeneca scores 0 on Better Health for All despite reaching 90.5 million people through access programmes and investing $13.6 billion in R&D in 2024 (19.7% of its $69.1 billion total revenue). The company had seven product recalls in 2024, none at the patient level, and no critical findings from 49 inspections.
AstraZeneca scores -50 on No War, No Weapons. The company reported $576 million in U.S. Department of Defense contracts in fiscal year 2022. Its Russian subsidiary sales rose 30% to GBP 838.8 million in 2024, despite the war in Ukraine.
On Safe & Smart Tech (-50), a 2021 data exposure left internal server credentials and some patient data on GitHub for over a year. On Kind to Animals (-60), AstraZeneca used 205,757 animals in testing in 2024, an increase from 182,458 the previous year.
View AstraZeneca's full score breakdown
UnitedHealth: 190 Million Records Breached
UnitedHealth scores 0 on Better Health for All. The company's HouseCalls programme performed 2.9 million preventive home care visits in 2024. Its shift to value-based care reduced hospitalisations for chronic patients by 12%. It has committed over $156 million since 2020 to expand the healthcare workforce, including a $100 million investment to support 10,000 clinicians from underrepresented communities.
UnitedHealth scores -80 on Safe & Smart Tech -- the lowest in this analysis. The February 2024 Change Healthcare cyberattack exposed the medical data of 190 million individuals. The response cost $2.2 billion. The breach was traced to the absence of basic multi-factor authentication. Change Healthcare was also criticised for including hidden "noindex" code on its data breach notice and for a four-month delay in notifying affected individuals.
Additionally, UnitedHealth's nH Predict AI system faces legal challenges for an alleged 90% error rate in denying patient coverage, with plaintiffs demanding access to the algorithm's source code and data.
On Fair Pay & Worker Respect (+40), a 2023 review confirmed dollar-for-dollar pay equity across gender and race. On Honest & Fair Business (-10), the U.S. Department of Justice initiated an investigation in May 2025 into UnitedHealth's Medicare billing practices, and a $1 million fine was levied for not covering all federally approved birth control methods.
View UnitedHealth's full score breakdown
Johnson & Johnson: Drug Pricing and Talc Penalties
Johnson & Johnson scores -40 on Better Health for All. The bedaquiline pricing investigation in South Africa and the 340B rebate model weigh against a $50 million Africa health worker fund. On integrity (-20), over $1 billion in penalties in three years includes the $700 million talc settlement and a $302 million California drug safety penalty.
J&J is the only company in this analysis with a positive climate score (+10 on Planet-Friendly Business), with 87% renewable electricity and a 23% emissions reduction between 2021 and 2023.
For the full head-to-head with Pfizer, see our Pfizer vs J&J comparison.
View Johnson & Johnson's full score breakdown
Pfizer: Drug Price Hikes and Regulatory Penalties
Pfizer sits last in this ranking, scoring -60 on both Better Health for All and Honest & Fair Business. The health score reflects Paxlovid's doubling to $1,390 per course, five drugs with above-inflation increases, and a $25.5M antitrust settlement for delaying a generic. The integrity score adds a GBP 63 million epilepsy drug pricing fine and a $60 million kickback settlement.
Pfizer's "Accord for a Healthier World" aims to provide medicines at cost to 45 countries. As of September 2024, ten countries are participating.
On Fair Pay & Worker Respect (+10), a 2025 pay equity study found near-parity across gender and race, though a $2 million settlement in 2023 resolved discrimination affecting 86 female employees.
For the full head-to-head with J&J, see our Pfizer vs J&J comparison.
View Pfizer's full score breakdown
The Access vs. Pricing Spectrum
The single dimension that should define a healthcare company -- Better Health for All -- is also the dimension that most clearly separates the top of this ranking from the bottom. The divide is about access and pricing, not governance or worker treatment.
Access Leaders: Merck (+30) -- voluntary generic licensing in 100+ countries, HPV vaccines at access prices, pipeline addressing 83% of top 20 global disease burdens, 33,000+ health workers trained via Project ECHO. GSK (+20) -- malaria vaccine (RTS,S), RSV vaccine, licensing agreements expanding access in lower-income countries. AbbVie (+10) -- 235,000 free medicines provided, products in 63 low- and middle-income countries.
Neutral: AstraZeneca (0) -- 90.5 million people reached through access programmes, but Russian subsidiary sales rose 30% during the Ukraine war, and $576M in DoD contracts complicate the picture. UnitedHealth (0) -- 2.9 million preventive home visits, but the 190-million-record data breach and an AI system with an alleged 90% error rate in coverage denials dominate the record.
Pricing Concerns: J&J (-40) -- bedaquiline pricing investigated in South Africa, 340B rebate model criticised, offset partially by $50M Africa health worker fund. Pfizer (-60) -- Paxlovid doubled to $1,390 per course, five drugs with above-inflation increases, $25.5M antitrust settlement for delaying a generic.
What Separates Ethical Healthcare Companies From the Rest
The spectrum above reveals a pattern. The companies that score highest on health access have documented voluntary licensing programmes and measurable access expansion. The companies that score lowest have documented pricing actions that reduced access to essential medicines.
Corporate integrity is poor across the board -- not a single company in this analysis scores above 0 on Honest & Fair Business. Billion-dollar settlements, antitrust charges, and kickback allegations are industry-wide.
Data security is the emerging fault line. UnitedHealth's -80 and AstraZeneca's -50 on Safe & Smart Tech reflect documented breaches and security failures. Merck is the only company with a positive tech score (+20), built on APEC Cross Border Privacy certification and an external AI ethics advisory panel.
For the detailed head-to-head comparison of the two lowest-ranked companies, see our analysis of Pfizer vs Johnson & Johnson on ethics.
How to Evaluate Healthcare Stocks on Ethics
If you hold healthcare stocks -- directly or through a fund -- the scores above provide a starting point. Focus on the dimensions most relevant to this sector: health access, corporate integrity, and data security.
For individual company deep dives, search any company at mashinii.com/score/search. To score your full portfolio, including healthcare holdings within index funds, use the portfolio audit tool. For broader context on companies facing documented controversies, see our court records analysis.
How We Score
Every score is backed by cited, independent evidence -- regulatory penalties, court outcomes, verified reporting, and third-party audits. No self-reported data. Learn more about our methodology.
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