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Opportunities amidst challenges


20161015ep02MSF’s seven-year-old appeal campaign to reduce flu vaccine prices has finally borne fruit. While Pfizer has not responded to the pleas to reduce the price of its pneumococcal conjugate vaccine (PCV) for humanitarian organisations like MSF, GSK has announced that it will sell its vaccine to MSF and other such organisations at the lowest global price.

According to an MSF release, it paid 60 euros ($68.10) per dose for Pfizer’s PCV to vaccinate refugee children in Greece earlier this year, which is 20 times the lowest global price. But GSK’s response means nothing to children in developing countries, unless, as MSF urges, it prices the flu shot at $5 per child, for the three recommended doses, for all developing countries.

Pfizer’s PCV brought in revenues of $30 billion in the past seven years. With such earnings at stake, escalating research budgets and no new products in the pipeline, is it realistic to expect pharma companies to concede ground? GSK’s announcement is a ‘positive and critical step forward for children in emergencies’ but this is a long journey towards giving “every child … a fair shot at being protected against pneumonia,” as Vickie Hawkins, Executive Director, MSF UK puts it.

In mid September, the United Nations Secretary-General’s High-Level Panel (UNHLP) on Access to Medicines’ report on promoting innovation for, and access to, health technologies highlighted the severe deficit of new medicines. The report also highlighted the vast difference in reported costs of R&D. While a 2016 study conducted by the industry-funded Tufts Centre for the Study of Drug Development pegged the average total cost of bringing a new medicine to the market at $2.56 billion to $2.87 billion. Even after adopting the pharma industry practice of adjusting for risk of failure, the non-profit DNDi analysed its own R&D costs for developing a new chemical entity at $130 million to $195 million. The report concedes that R&D costs will vastly differ between molecules/ technologies and apple-to-apple comparison is not possible but calls for more transparency from pharma companies when declaring the costs of R&D.

The need for speedy implementation of these recommendations can be gauged by the increasingly frequent outbreaks of epidemics. For instance, a time-based analysis of the pattern of emerging infectious disease (EID) over the last six decades predicts that five new EIDs will emerge each year if no mitigation policies are  adopted now. Hence, priority setting and coordination by global non-profits and governments will be important.

There are signs that pharma companies are also recognising the opportunities amidst the challenges. For instance, Zydus and Takeda have come together for development and  commercialisation of a vaccine for chikungunya. India is one of the 60 countries where EIDs like chikungunya, Zika and dengue, are becoming increasingly common. The future lies in such partnerships so let us hope they deliver the results.

Viveka Roychowdhury

[email protected]

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