Should covid-19 vaccines and drugs be “not for profit”?
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o755 (Published 30 March 2022) Cite this as: BMJ 2022;376:o755
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Dear Editor
On reading the BMJ articles on covid vaccines in the 2nd April issue, I noted a discrepancy across articles. Mohga Kamal-Yanni, in the head to head, argued for covid vaccines to be not for profit, citing the success of the agreement between Oxford University and AstraZeneca. They stated that this agreement required the company to sell at non-profit price to low and middle income countries. And yet, later in the journal, Yamey and colleagues in their analysis stated that the Oxford AstraZeneca vaccine sold for $3.50 to the EU, $5.25 to South Africa and $7 to Uganda.
Does this mean the agreement commended by Mohga Kamal-Yanni was not as effective as suggested? For what it is worth, surely the 'right thing' would be for pharmaceutical companies to pay back their R&D grants out of profits made from the drug or vaccine developed from that grant. Perhaps a model rather like student loans can be developed. If students have to pay back on benefits received later, with interest, surely the fat cat pharmaceutical companies could do likewise.
Dr Heidi Hales
Competing interests: No competing interests
Re: Should covid-19 vaccines and drugs be “not for profit”?
Dear Editor
Thank you to Heidi Hales for her comment. Indeed, it is correct to say that Oxford insisted on non-profit price and AstraZeneca agreed, as evident in their announcement. (1) The price agreed with Africa Union is US$ 3/dose. (2)
However, the prices she quoted are also correct. The reality is that AstraZeneca signed a normal commercial secret bilateral deal with Serum; the biggest vaccine-producing company in India. It seems that the deal did not include conditionalities on price. Serum sold the vaccines at the price mentioned in her rapid response. Serum said it is making some profit while Astra Zeneca said that the cost of production varies by company. (3)
This is a glaring example of why many activists, including The People Vaccine Alliance, call for pharmaceutical companies to share technologies and intellectual property via the WHO COVID-19 Technology Access Pool (C-TAP). This pool is based on the Medicine Patent Pool that was created for HIV medicines and now expanded to others and is a key partner of C-TAP. These pools negotiate on behalf of public health, not commercial profit and therefore they secure low prices. Transparency is also a key ingredient so once a license is signed, it is made public and its details become available for public scrutiny.
The idea of companies paying back the cost of R&D is interesting, but actually companies consider that cost as a commercial secret and we never know what is included and what is the real cost. The proposed idea would not ensure diversification of production and therefore monopoly on availability to developing countries remains. Moreover, it does not curb the very high price of the product after the company pays back the cost of R&D. Companies benefit from taxpayer’s money three times: through governments’ funding of R&D; through high price of products; and again, through escaping paying proper tax. All three routes must be tackled.
References:
1) https://www.ox.ac.uk/news/2020-04-30-oxford-university-announces-landmar...
2) https://www.business-standard.com/article/current-affairs/at-2-06-per-do...
3) https://www.politico.eu/article/astrazeneca-vaccine-cost-higher-in-poore...
Competing interests: No competing interests