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US public investment in development of mRNA covid-19 vaccines: retrospective cohort study

BMJ 2023; 380 doi: https://doi.org/10.1136/bmj-2022-073747 (Published 01 March 2023) Cite this as: BMJ 2023;380:e073747

Linked Editorial

Financing covid-19 mRNA vaccines

Linked Analysis

High drug prices are not justified by industry’s spending on research and development

Rapid Response:

Re: US public investment in development of mRNA covid-19 vaccines: retrospective cohort study. Private funding key to decades of mRNA vaccine development pre-pandemic

Dear Editor,

The headline that the US government invested $31.9 billion to develop, produce, and purchase mRNA COVID-19 vaccines conflates support for R&D and financing for procurement and it runs the risk of eclipsing the private funding involved in developing mRNA COVID-19 vaccines.

In the decade preceding COVID-19, the Moderna and BioNTech mRNA platforms were bankrolled by investors, high net worth individuals and big pharma, with very limited public money on the books. Moderna secured $3.8 bn at risk to develop its mRNA platform. To give a sense of proportion, in 2013, it made an agreement with AstraZeneca for $240 mm, with the US Department of Defense providing $25 mm [1]. BioNTech had raised in two years between 2017 and 2019 around $720 mm from private finance and had accumulated more than $400m of debts [2]. These companies had been burning money for years, and still, they decided to risk it all on developing a vaccine.

Once the pandemic struck, private investors were first in line to support the companies’ mRNA COVID-19 vaccine ambitions. Moderna secured $1.3 bn to prepare for supplying its new vaccine [3]. The Strüngmann brothers were a lifeline for BioNTech investing $14.3 mm [4]. Pfizer later advanced to BioNTech a 50% share of development costs from its $2 bn COVID-19 war chest, all at risk. [5]

If we go along with the numbers of the study, only 8% of the $31.9 bn of US public funds, e.g. $2.7 bn, supported R&D and this, after private investors had committed billions at risk to supporting the mRNA vaccine. 92%, e.g. $29.2 bn of the $31.9 bn, were used to purchase doses of the mRNA vaccine should it prove safe and effective. While this is an impressive amount, only a small proportion of the advance was truly at risk, should the vaccine not work. Since it did, mRNA vaccines ended up helping protect the lives of millions and contributed dramatically to lessening the burden of the pandemic on hospitals and the economy. For example, according to a 2021 study, COVID-19 vaccines saved the U.S. economy approximately $438 bn [6].

Three of the (pre-pandemic) biggest innovative vaccine companies (Sanofi, GSK, MSD) attempted but failed in developing a COVID-19 vaccine in 2021, and as a result either gave up, or only succeeded by the end of 2022. Today, mRNA COVID-19 vaccines are seen as gamechangers, but there was absolutely no guarantee that the technology would work. In early 2022, from over 130 COVID-19 vaccines in clinical trials, only 23 were mRNA-based candidates [7], including CureVac which did not deliver on its promise [8]. Only two of these attempts paid off.

Notwithstanding the risks involved, private investment will continue to drive innovation. Moderna plans to spend $4.5 bn in 2023, including 15 vaccine programs targeting priority pathogens identified by the World Health Organization as threats to global health and investing in vaccine manufacturing in Kenya. BioNTech is launched in an end-to-end mRNA vaccine manufacturing network in Africa [9] as well as running five clinical trials for TB, malaria and other infectious disease vaccines [10].

Government partners have a critical role to play as does the private sector in fostering an innovation environment that can take on a Disease X, but this requires a thriving innovation environment where public and private sector scientists can have unimpeded and swift access to emerging pathogens and an R&D ecosystem supported by a tried and tested intellectual property framework.

Few government investments can boast a benefit to society to the tune of USD $70.5 trillion [11], public funding towards mRNA COVID-19 vaccines provided a phenomenal return on investment. This should be celebrated.

1 AstraZeneca Makes a Bet on an Untested Technique, 21 March 2013, New York times https://www.nytimes.com/2013/03/21/business/astrazeneca-to-pay-240-milli...
2 The Vaccine, Inside the Race to Conquer the COVID-19 Pandemic. Author: Joe Miller with Dr. Özlem Türeci and Dr. Ugur Sahin. In 2017, the company raised $270 from fund managers (organised by Credit Suisse), this money allowed BioNTech to build the production facilities that was crucial to manufacturing the COVID-19 vaccines doses for clinical trials in 2020. In 2019, BioNTech raised $325 million from existing backers. In the process of drumming up funding of their IPO in 2019, BioNTech raised $125 million.
3 Markets Now – 19 May 2020, Byrce Elder, Financial times https://www.ft.com/content/547d0f20-44c1-4d5d-8bf3-d7b967a47cb2
4 Early backers of vaccine maker BioNTech in $719 million payday, Reuters
https://www.reuters.com/article/us-health-coronavirus-biontech-investors...
5 Pfizer and BioNTech Announce Further Details on Collaboration to Accelerate Global COVID-19 Vaccine Development, press release, April 9 2020
https://www.businesswire.com/news/home/20200409005405/en/
6 Anusuya Chatterjee et. al., Economic Savings in America: A story of Public-Private Partnership in Rapid COVID-19 Vaccine Development and Deployment, HEARTLAND FORWARD (Dec. 18, 2021), https://heartlandforward.org/wp-content/uploads/2021/12/Economic-Savings...
7 Gábor Tamás Szabó, et al, COVID-19 mRNA vaccines: Platforms and current developments, VOLUME 30, ISSUE 5, P1850-1868, MAY 04, 2022, Molecular Therapy https://www.cell.com/molecular-therapy-family/molecular-therapy/fulltext...(22)00099-5
8 Annalee Armstrong, With failed COVID shot still dragging on earnings, CureVac tries to turn page to next-gen mRNA tech, May 25, 2022. FierceBiotech https://www.fiercebiotech.com/biotech/failed-covid-shot-still-dragging-e...
9 Kevin Dunleavy, BioNTech kicks off ambitious vaccine manufacturing initiative in Africa, June 23, 2022, FiercePharma https://www.fiercepharma.com/pharma/rwanda-biontech-begins-construction-...
10 Jams Waldron, Life Beyond COVID: BioNTech lines up 5 infectious disease vaccines trials for 2023, Nov 7, 2022. FierceBiotech https://www.fiercebiotech.com/biotech/life-beyond-covid-biontech-lines-5...
11 The Direction of Travel, World Intellectual Property Report 2022 (wipo.int) page 19/20 page.

Competing interests: No competing interests

08 March 2023
Thomas B Cueni
Director General
IFPMA
IFPMA, Chemin des Mines 9, 1202 Geneva, Switzerland