Why we rejected Pfizer’s donation offer of pneumonia vaccines
medium.com
medium.com
> Countries, which continue to voice their frustration at being unable to afford new and costly vaccines such as PCV, need lower prices as well to protect children’s health.
Medicine and the pharmaceutical industry must strike a balance between the increase in innovation only healthy competition can bring (the promise of capitalism) and the public utility of their discoveries.
When that doesn't happen governments sometimes are forced to step in and take harsh measures. It happened in Brazil in the first years of the XXI century, when the government forced compulsory licensing of anti-HIV drug patents [1] so it could produce it cheaply on their own laboratories.
[1] http://www.doctorswithoutborders.org/news-stories/press-rele...
The mistake rather lies in the fact that the patents were granted. If you want competition instead of a monopoly dictating the prizes you should better not allow patents in this area.
We could also reduce the cost of bringing new therapies to market by having the FDA say "if your drug is approved by the EU, you can sell it in the US" as per S. 2388
Given that medical research is probably as close as you can get to a textbook case where patents are useful, and how obviously true many smart people think this statement is, there just _must_ be lots of robust peer reviewed academic research empirically supporting that statement.
Could someone point me to one such peer-reviewed paper?
Note that there are also opposing views. Switzerland did not have pharmaceutical patents until 1978. A quote from a famous anti-IP book[1]:
"In particular, at least between 1850 and 1980, most drugs and medical products should have been invented and produced in the United States and the United Kingdom, and very little if anything in continental Europe. Further, countries such as Italy, Switzerland and, to a lesser extent, Germany, should have been the laggards of the pharmaceutical industry until recently. Instead the opposite was true for longer than a century"
Even if 100% of drugs are available patent-free in Germany, it wouldn't be very helpful to people living in the US.
This is exactly the sort of thing that TTIP is trying to do. For some reason, though, there is a lot of opposition to TTIP, not only in general, but on exactly this kind of provision.
Some countries may be willing to ease approval requirements without regard to safety to draw pharmaceutical company operations there and in others whether through official policy or corruption agencies may become fee for approval businesses.
Once reciprocation is in place whether through treaty or act of Congress, due to the power of the pharmaceutical companies it will become almost impossible to end even when abuse is apparent.
In regards to S. 2388 I also oppose the provision allowing Congress to override the FDA decision to not allow a particular drug or device. It is yet another attempt to make what should be scientific decisions political ones.
But what reason does the pharmaceutical company have to reduce the drug price in this case if it has a patent (i.e. a monopoly to dictate the price) instead of simply having more profit because of these (potential) changes in regulations?
I think that you misspelled collaboration.
And private research is not always positive: http://www.foodandwaterwatch.org/insight/public-research-pri...
What?? Is it a "DONATION" or a "CONTRACT"? I don't understand how this could be called a donation if it has "strings attached".
Once I donate money to a charity, I expect them to spend it wisely, but I do not make them sign a freaking contract!
As an example, lets say you give money to a charity. You could require the funds be used to create and administer a scholarship for youth from your home town. You could not require the funds be used for a scholarship for children who live in your household.
This is based on what I've incidentally learned working for a non-profit. I'm not an accountant or a lawyer, so I might have missed some nuance, but I think that's the gist of it.
Here's a link to some information on managing restricted funds:
https://www.thebalance.com/restricted-unrestricted-nonprofit...
Since they DWB cannot get the vaccine on their own (buying it), donations make them beholden to the will of the donor. So if Pfizer or GSK say, "Hey, we REALLY would like these vaccines to not go to North Korea", and DWB sends vaccines to NK, then the donors can/will take that into consideration when donating the next round. That gives drug companies control over the healthcare that these organizations are providing.
And donations and funding only get more complicated from there. It is, indeed, possible for MANY strings to be attached to donations.
Moreover most private donations and public subsidies come with strings attached.
Edit - and yes, I realize money is fungible, and to an extent donating for a stadium frees up funds that aren't earmarked, but if everybody donates for stadiums and nobody donates for general spending, there isn't much to be done (beyond asking the donors to revise contracts).
When it comes down to it I am more against using children as pawns to make political statements. If the other drug is more cost effective then people should just skip the Pfizer drug until they in turn adjust pricing for the market.
Isn't this what they're doing? They specifically mention that a competitor (GSK) has lowered their prices for the same vaccine, so presumably they'll use that instead until Pfizer lowers the price, exactly as you're suggesting.
wholesale price $17.00
(developing world src:wikipedia)
AMC subsidised price $3.50
GSK Offer $3.05
MSF Want $1.66
There's also the AMC programme (Gates Foundation and 5 Govt contributions), GAVI (Gates, World Bank, WHO, Unicef).
GSK charge less than Pfizer as their vaccine covers slightly fewer strains.
GAVI seems to have been remarkably successful [1], and $10bn in funding over its lifetime, 75% infectious disease control, 25% basic healthcare. They're in more countries than currently targeted but rollout within countries is slightly behind. Countries are still applying to join GAVI. They have systematically increased manufacturers for vaccines, including developing world producers for all.
Two or three more manufacturers of Pneumococcal vaccine are in pipeline. Not clear when, but MSF seem to indicate next year for first.
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So, what do I get from that?
20, OK 25 minutes doesn't get you much, reports tend to be long. :)
I've a new found respect for Bill Gates. From a world where vaccination rates were declining in the 90s, he's achieved a huge change.
$3.50 a dose is perhaps a better ask, given strains covered and other subsidised prices. Get that then ask everyone to go lower. Or ask $1.66 and get ignored.
Can't quickly find out research cost of these, or production cost, so impossible to estimate what cost price becomes, or additional costs to research additional developing world strains. High price doesn't only mean profiteering.
Products appear to be in pipeline from GSK (in collaboration with London School of Hygiene & Tropical Medicine, and Medical Research Council, Gambia) - near Phase III, Serum Institute of India - under development, Merck has a candidate going into Phase II. So competition coming soon(tm).
I suggest you spend 20 minutes thinking about the impact of medication funneled through corrupt gov. in third world countries. And the influence of gates on those govs.
"To avoid these risks and to limit the use of in-kind medical products donations, the World Health Organization (WHO), and other leading global health organizations such as UNICEF and Gavi, the Vaccine Alliance, have clear recommendations against donation offers from pharmaceutical corporations." My emphasis.
GAVI, an organisation Gates was involved in creating, and has given $2.5bn (a little under 22% of their total budget) to since 99 is agreeing the recommendation.
They're in 75 of the poorest nations on earth - of course there is some fraud and corruption, but vaccination is progressing very well and more countries are continually joining. I'm sure they try to minimise it.
He's put another $1bn into two other vaccination programmes: polio and malaria.
Yes, I stand by what I said.
Would you prefer MSF, a fine charity with an honourable history but almost endless call on their limited resources do it? In addition to the training, basic healthcare, vaccination, disaster relief, clean water supply, and refugee missions? And probably a dozen other things I forget. They're not immune to fraud and corruption either - no organisation that size can be. I'm sure they try to minimise it too.
What would you do?
"Donations can also undermine long-term efforts to increase access to affordable vaccines and medicines. They remove incentives for new manufacturers to enter a market when it’s absorbed through a donation arrangement. We need competition from new companies to bring down prices overall — something we don’t have currently for the pneumonia vaccine. Donations are often used as a way to make others ‘pay up.’ By giving the pneumonia vaccine away for free, pharmaceutical corporations can use this as justification for why prices remain high for others, including other humanitarian organizations and developing countries that also can’t afford the vaccine. Countries, which continue to voice their frustration at being unable to afford new and costly vaccines such as PCV, need lower prices as well to protect children’s health."
I don't see that as a bad thing.
It isn't that they couldn't use the donations or that they won't help people. Unfortunately, restrictions, both transparent and implied, means that they can't always use the donation where it is actually needed. Furthermore, those same donations actually hinder them from helping folks in the future.
Long term planning and learning from history and working with other charities and all that stuff - they actually do that.