Pressure mounts for lower vaccine prices

Last month, Médecins Sans Frontières (MSF) surprised Pfizer by refusing a donation of one million doses of the company’s pneumonia vaccine

With high numbers of children who are not immunised against pneumococcus (global coverage for three doses of the vaccine reached just 37% in 2015), MSF decided it was more important to press the company to lower the prices of its pneumococcal conjugate vaccine, Prevnar 13®.

The Executive Director of Doctors Without Borders/MSF in the US, Jason Cone, explained in an editorial why the international medical humanitarian organisation had knocked back what seems – at face value – like a generous offer.

“This is not a decision that we took lightly, since our medical teams working in the field witness the impact of pneumonia every day. Pneumonia claims the lives of nearly one million kids each year,” says Cone in Medium.

“Although there’s a vaccine to prevent this disease, it’s too expensive for many developing countries and humanitarian organizations, such as ours, to afford.

“As the only producers of the pneumonia vaccine, Pfizer and GlaxoSmithKline (GSK) are able to keep the price of the vaccine artificially high; since 2009, the two companies have earned $36 billion on this vaccine alone. For years, we have been trying to negotiate with the companies to lower the price of the vaccine, but they offered us donations instead.

“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 organisations and developing countries that also can’t afford the vaccine.”

Cone points out that in September, after years of negotiations and months of public campaigning, GSK announced that it would offer its pneumonia vaccine to humanitarian organisations at the lowest global price.

“This is an important step towards a sustainable solution for humanitarian organisations that wish to extend the benefits of pneumonia vaccination to children caught in crisis,” he says.

A Pfizer spokesperson told The Atlantic that the company “strongly disagrees” with MSF’s decision, and that “to suggest that donations are not valuable defies logic.”

“Pfizer is committed to making vaccines available to as many people as possible, particularly those needing emergency humanitarian assistance,” said a company spokesperson.

However other public health advocates are now coming out calling for the companies to lower prices.

In an editorial published in the BMJ this month, ‘Fair vaccine pricing please, not random acts of charity’, two authors with a background in medicines policy and economics echo Cone’s calls.

Els Torreele from the Open Society Foundations, New York, and Mariana Mazzucato, from the University of Sussex in the UK, believe “vaccines are essential goods produced collectively to safeguard children, wherever they live.”

They argue that price discrimination is serious when it comes to a product such as vaccines.

“Price discrimination—that is, charging customers differently depending on their ability or willingness to pay—is a sign of market power. This behaviour is controversial for any type of good, such as food, and treated seriously by competition authorities. In the case of vaccines or other essential health products—public goods that should be generated according to public value considerations—the matter is extremely serious,” write Torreele and Professor Mazzucato.

“Pneumonia vaccines are likely to cost less than a dollar to produce (based on estimates for similar vaccines) but are typically being sold at $120-$160 (£96-£130; €110-€150) per dose in wealthy countries, and at least three doses are required to protect a child. High prices stand in the way of access, but they guarantee great profits: Pfizer’s revenue from this vaccine was $6.2bn in 2015.”

They suggest that the markets need to be shaped by public policy.

“One critical step could be to agree on a fair price that takes into account the research and manufacturing costs, the public research contributions, and the public health importance of vaccines.

“This, rather than charitable donations meant to mask the system failures of a profit maximising healthcare economy, would be a beneficial corrective for public health.

“The right price for vaccines must take into account the value of their collective creation but also the fact that they are essential goods produced collectively to safeguard the vulnerable—no matter where they live,” conclude Torreele and Professor Mazzucato.


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