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The race for a coronavirus vaccine has sparked a debate about how much the hits will cost and who will pay for them, as prices range from $ 3 to more than $ 30 per dose and public health advocates, including Bill Gates, call for a maximum price for poor countries. .
Even when billions of dollars of public money have been invested in vaccine development, drugmakers have been reluctant to discuss how they will price an injection. They say it’s the result of many factors, including efficiency, test results, development and manufacturing costs, competition, demand, and whether the buyers are private groups, such as insurers, or government agencies.
The urgency and global spread of the pandemic have added layers of complexity. In the rush to develop the right vaccine, companies are experimenting with different technologies. In an unprecedented move, some drug makers plan to allow other companies to manufacture their doses, further complicating cost calculations.
The American biotech company Moderna says it will charge a maximum of $ 37 per dose for its Covid-19 vaccine, one of the highest prices disclosed to date © Chandan Khanna / AFP via Getty
The price of all vaccine offers has been kept secret, and companies and public institutions have defended their right to confidentiality. But people briefed on talks between drug makers and the European Commission say AstraZeneca has sold its jab for around $ 3 to $ 4 a dose in deals with the EU, while Johnson & Johnson’s injection and vaccine jointly developed by Sanofi and GSK have come to around $ 10 per dose.
By contrast, Moderna, a newer and still-losing company, has tried to launch its vaccine at $ 50 to $ 60 per course of two injections, after initially asking for nearly double that amount. Other biotech companies, like CureVac, have said they would seek an “ethical margin” in their prices.
Pressure from civil society and media reports has prompted some companies to disclose projected list prices, with Moderna doing so in August, posting a maximum price of $ 37 per dose.
One of China’s vaccine pioneers, Sinovac, this week began selling its vaccine in select cities at $ 60 for two injections as part of an emergency use program with hundreds of thousands of participants.
At the center of the discussion is both an ethical and a practical question: whether pharmaceutical corporations should work with rich countries to ensure that charges to poor countries are limited.
Mr Gates, for example, told the Financial Times that drug companies should support a system whereby rich countries subsidize vaccines so that poor nations pay $ 3 or less per dose.
“Pricing needs three tiers where rich countries are paying a large portion of the fixed costs, middle-income countries are paying some of the fixed costs, and poorer countries are paying a true marginal cost,” said Gates, co-chair of the Bill and Melinda Gates Foundation said in an interview.
The billionaire software developer turned health philanthropist says that any successful vaccine must be available where it is needed at a non-prohibitive cost. “In fact, we had to explain to a couple of CEOs of pharmaceutical companies that, even in the context of non-profit organizations, this classification is absolutely necessary to maximize human benefit.”
Some manufacturers in countries like India, which has a large drug production industry, have criticized Western pharmaceutical companies that they believe they are trying to prop up prices by not increasing production to meet demand.
“They don’t want to give it to the rest of the world because they will have to compete with me for $ 3 [a dose]”Said Adar Poonawalla, CEO of the Serum Institute of India, the world’s largest vaccine manufacturer. “We are making a small margin, but that is normal business,” he said. He added that higher production costs in Europe did not justify the price difference between his company’s products and those of some Western vaccine producers.
Gavi, the UN-backed vaccine alliance and the Gates Foundation last month expanded an agreement with the Poonawalla Institute to deliver up to 200 million doses of AstraZeneca and Novavax licensed candidate vaccines to low- and middle-income countries to a maximum of $ 3 per year. dosage: with the option of increasing the order volume several times.
Other initiatives to support global access include the efforts of the Coalition for Innovations in Epidemic Preparedness, which co-funds nine candidate vaccines with a mix of partners that include large corporations and academic institutions.
But the Covax initiative, the World Health Organization’s flagship program to provide 2 billion Covid-19 vaccines to the poorest countries by the end of next year, had to delay its full launch until this month after it struggled to enroll. to rich countries.
Gates said he was hopeful that competition would keep prices low in the long term. “By the end of the year, or certainly in the first quarter of next year, chances are, of the top six vaccines, two or three of them will show efficacy, and then we’re off to the races,” he said.
But he also acknowledged that prices for certain vaccines are likely to remain higher than others. For example, mRNA vaccines, such as those from Moderna and the association Pfizer and BioNTech, are more expensive to manufacture than adenovirus vector-based vaccines such as the injection developed by AstraZeneca and the University of Oxford, he said.
A fundamental challenge to effective planning and pricing is that everyone involved has had to crush the normal decade-long vaccine development cycle in a fraction of that time, said a senior EU official.
“Now we are trying to compress this to 12 to 18 months and not just produce some vaccines, but produce them in the order of hundreds of millions, even billions, in volume,” the official said. “This is a risky business.”
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