This week, Pfizer giddily announced that preliminary results from a coronavirus vaccine trial they’re conducting suggest the vaccine is more than 90% effective. By comparison, influenza vaccines are typically 40 to 60% effective.
Preliminary findings also suggest that the vaccine is safe, so Pfizer is planning to ask the FDA for emergency authorization of the vaccine as early as this month.
Assuming the rest of the trial goes well, and with expedited FDA approval, Pfizer estimates they can have up to 40 million doses produced before the end of 2020.
It looks extremely promising. I’m genuinely hopeful that production and distribution of a vaccine will mark the beginning of the end to this nightmarish pandemic.
But, beyond the standard concerns about the safety and efficacy of the vaccine, I’m worried about cost and accessibility. Our salvation sits squarely in the hands of for-profit companies who have the final say in how much the vaccine costs and, whatever they say publicly, their bottom line — not our well being — is their top priority.
I hope you can forgive me my skepticism. You see, I have firsthand experience with trying to get my insurance company to approve life-saving, but prohibitively expensive, drugs.
Once upon a time, in cancerland
Five years ago I spent my days micromanaging my daughter’s cancer treatment. It was not uncommon for me to spend weeks, or even months, trying to get our insurance company to approve the targeted chemotherapy drugs that my daughter’s pediatric oncologist prescribed to treat her rare tumor.
Her cancer had metastasized within six months of diagnosis (in 2012). By 2015, she had many tumors in her lungs and throughout her abdomen.
Targeted drugs that attack specific gene mutations had successfully slowed the progression of her disease, but the drugs always stopped working after a few months, so new drugs needed to be added or her existing dose revised. This required new prescriptions for very expensive drugs (one of the drugs she was on, Ibrance — developed by Pfizer — costs about $13,000 for 21 pills).
Needless to say (but I’ll say it anyway), it took much jumping through hoops to get our insurance company to approve prescription changes.
Once, after two weeks of appealing insurance company denials and finally getting approval, I was so effusively grateful to the insurance rep who called me with the news, that I totally freaked her out.
But she didn’t know that the drug in question was the third oral chemotherapy treatment that my daughter’s oncologist had prescribed in a year, or that each time we switched to a new drug, we were subjected to the agonizing process of waiting and worrying about getting insurance approval. She didn’t know that with every scan that showed cancer progression, we were running out of options.
The targeted drugs that extended my daughter’s life caused few side effects. She’d been able to take them orally at home. They’d been far more effective than the harsher chemotherapy she’d received when she was first diagnosed.
She’d obviously needed these drugs, but our insurance routinely denied them, requiring multiple appeals before approval, because they were so expensive. The question of why they cost so much wasn’t an easy one to answer, but I made it my mission to try.
Profit is more important than saving lives
A 60 Minute piece that aired in 2015 called, “The Cost of Cancer Drugs,” shed some light on how pharmaceutical companies operate when it comes to setting prices for drugs.
The segment featured Dr. Leonard Saltz, Chief of Gastrointestinal Oncology at Memorial Sloan Kettering, who estimated that the cost of cancer drugs was roughly $100,000 a year back in 2015.
At the time, Dr. Saltz had made the decision not to include a new drug, Zaltrap, as a treatment option for his patients because it was more than double the price of Avastin, a drug which was equally effective and already on the market. This decision was revealed in an article in The New York Times and, shortly after, Sanofi dropped the price of the new drug by half.
This bears repeating: Sanofi dropped the price of Zaltrap less than a month after the original New York Times piece was published. I had my answer to why pharmaceutical companies charge so much for cancer drugs — it’s because they can.
In fact, an article published in Science Daily as recently as August 2020, revealed the results of a study that found absolutely no correlation between the clinical benefits of cancer drugs and their exorbitant prices.
Drugs are so expensive because profit is more important than saving lives. It’s not, as pharmaceutical companies have been saying for years, because the cost of research and development is so high. A 2019 report by The World Health Organization (WHO) found that the cost of R&D and drug production “may bear little or no relationship to how pharmaceutical companies set prices for cancer medications.”
Big pharma, of course, disagrees, countering this report by claiming the WHO’s findings are “deeply flawed” and that the report “fails to account for the value that cancer medicines provide to patients, health care systems and societies.”
I don’t find this statement by PhRMA, the trade group that represents the pharmaceutical and biotech industries, particularly comforting. It’s a pivot away from the “recouping our R&D costs” talking point, to something considerably more ominous (but surprisingly truthful).
They’re basically saying they’re setting the price so high because people will pay it. When the alternative is death, you find the money. Also, and this is key, big pharma doesn’t need all of us to pay up — they only need enough of us (and our insurance companies) to comply, so they can continue making roughly $14.50 for every $1 they spend on research and development. As an added perk, they also get to claim hero status. Look at us! We’re saving the world!
Shouldn’t a vaccine that stops a pandemic be free?
As of today, COVID-19 has killed more than 1 million people globally. Should the development of a vaccine that stops this carnage rest within the spotless laboratories of companies whose top priority is profit? Why aren’t more people asking this question?
I know the vaccine will cost much less than my daughter’s cancer drugs, but so what? Pfizer and other companies will be distributing billions of doses of the vaccine — that adds up to billions of dollars, much of it subsidized by governments (at least, at first) so their citizens can gain access.
At a price per dose of about $19.50 for Pfizer’s 2-dose vaccine, the company stands to make $15 billion in revenue. What’s preventing them from raising the price in the future? After all, who can put a price on the benefits of a viable vaccine? Well, who besides Pfizer?
I know I sound bitter, but I’ve been burned before. Immediately after my daughter’s cancer began progressing, her oncologist attempted to prescribe a very promising oral chemotherapy drug. From the time he decided to try this miracle drug to the moment it arrived at our door, two had months passed.
That was two months that the tumors had time to grow and spread.
That was two months of constant phone calls, faxing paperwork, and staying up late at night wondering if it would be approved, if it would ever arrive.
We danced that dance for the length of her treatment. It was a hard lesson in how much power pharmaceutical companies wield over my life and the lives of the people I love.
If the price of my daughter’s medication hadn’t been so high, would we have gotten her life-saving drugs more quickly? Would she have lived to see her 16th birthday? Would she, in fact, be alive today? These are questions that will haunt me forever.
And now, as we all wait anxiously for Pfizer or another company to produce a breakthrough coronavirus vaccine, I’m once again at the mercy of an industry whose primary motivation is profit.
And yet, I’m lucky. The vaccine won’t be prohibitively expensive for me, though I’m betting that’s not the case for everyone. That means people will continue to die from COVID-19 even though a treatment exists that can save them. This won’t change until healthcare stops being a commodity. I hope that happens in my lifetime, but at this point I seriously doubt it will.
Excerpts contained within this story were previously published on Huffpost.