High price of pharma war
WHEN my wife and I sat down a year ago to our Passover supper, known as the Seder, it was very different. Throughout our lives, and for most practising and secular Jewish families across the world, the festival of freedom from slavery in Egypt is the most celebrated.
Gatherings are multi-generational and it is traditional to invite strangers to witness ancient prayers and enjoy the feast. Covid19 changed that and, for the second year, lockdown means a streamlined table.
It has been a year of tragedy in Britain as the death toll surged, and the Anglo-Jewish community has endured more than a fair share of suffering. Yet there are many reasons to be grateful. Near to the top of the list is the excellence of UK life sciences and US- German work by Pfizer BioNTech, which has given a path out of plague for Britain, the US, Israel and other nations which embraced large-scale vaccination.
What is extraordinary is that the gift Britain has given to the world via the Astrazeneca vaccine has been undermined by EU squabbling and medical-politics in the US. As this paper has reported, up to £21bn of revenues have been forgone.
Far from being driven by ‘greed’, as Boris Johnson clumsily claimed, the driving force has been altruism.
From the start, AZ made it clear that its jab, at an average cost of $5 per dose, would be available to the first 3bn people to be inoculated at cost price. That compares with the $28-per-jab that Benjamin Netanyahu personally negotiated with Pfizer’s boss Albert Bourla and the $20-$40 price range for other vaccines including Moderna and Johnson & Johnson.
In a pandemic, the vaccine price ought to be irrelevant set against deaths, pressure on health care, the plunge in global output and lost jobs.
Yet it offers insight into why AZ’s pricing strategy has been a source of dissonance on both sides of the Atlantic. Documents uncovered by website Politico show that when Brussels climbed on the vaccine bandwagon on behalf of 27 states, it did so with the objective of negotiating the lowest price and maximum accountability. That tipped the scales in favour of buying as much of the AZ vaccine as possible, because it was cheaper and easily distributed, even though the Pfizer innovative RNA-based inoculation was developed in Germany.
What Brussels failed to recognise is that because Boris Johnson’s government had tipped £65.5m into the development of the vaccine, and it was first to the post in securing access, it gained exclusivity.
THE hugely ambitious EU deal was in second place. That was always going to be awkward for a supply chain in which some manufacture, components and testing was on the Continent. German and French leaders indulged in an act of self-harm when they questioned the efficacy of the AZ vaccine without evidence.
Because so much of the work was being done in the EU, tension was inevitable when the UK’s programme raced ahead at a sprint. In the US, Donald Trump’s Operation Warp Speed funded the development of six separate vaccines from US pharma. The cost price Astrazeneca jab was always going to be at a disadvantage. The first indication of nationalism playing a role came in September 2020 when Astrazeneca halted its UK trials after a woman patient died of myelitis.
After UK regulators checked the data, the trial was quickly resumed. The same data was submitted to the US and trials there were halted for seven weeks.
Had that not happened, the Oxford vaccine potentially could have been approved ahead of Pfizer.
Then again this week, the US Data and Safety Monitoring Board questioned the AZ efficacy data only to withdraw its objections a couple of days later when the information was updated and presented again.
No one should underestimate the power of the profits motive in American pharma. Vast amounts are spent on lobbying Congress, the Food & Drug Administration and everyone else who will listen.
Astra has been an easy target because it is an overseas company, operating a nonprofit model which could undermine the billions of dollars of payback from the US big six.
Yes, AZ’s chief Pascal Soriot, who has been in Australia, has been in the wrong place to douse the fires. But no one should underestimate how big a role politics has played in scarring the company’s humanity.