The quest for a Covid-19 vaccine cannot be infected by profit motives
In the early-to-mid 2000s, as concerns were growing about an avian flu outbreak, governments began stockpiling Tamiflu. The buying frenzy, sparked by clinical data provided by the drugmaker Roche, continued through 2009, when the WHO declared H1N1 swine flu a pandemic. As of 2017, government stockpiles represented roughly half of the U.S $18 billion spent on Tamiflu.
There was only one problem: Tamiflu didn’t actually do what Roche had reported it could do.
A review of Roche’s data by the reputed Cochrane group revealed that Tamiflu did not reduce hospitalisations and the data was inadequate to determine if it reduced the number of deaths. The World Health Organization (WHO), which had included Tamiflu on its list of essential medicines, downgraded the drug. But by then, Roche had already filled its coffers with billions of dollars of government money for stockpiles. This past January, a whistleblower filed a lawsuit in the U.S. alleging that Roche had bilked federal and state governments out of USD $1.5 billion by misrepresenting its clinical studies.
As the COVID-19 pandemic continues to spiral out of control, hopes are increasingly being placed on the development of a vaccine. The Tamiflu story is a cautionary tale for what happens when we place those hopes exclusively on the word of pharmaceutical executives who have every incentive to paint a rosy picture.
Within the space of a week, both Pfizer/ BioNtech and Moderna have released press statements claiming that their COVID-19 vaccines are, respectively, 95 and 94.5 percent effective in participants without evidence of prior infection. This is great news on its face, but there are a lot of reasons to be weary.
The data for both vaccines is highly preliminary. Pfizer/BioNTech’s results were based on an interim analysis of just 170 patients with COVID-19. And both Pfizer/BioNTech and Moderna chose to release their results via press release. The full results have not been published or reviewed by external experts. For example, the press statements do not reveal which sub-group of infected patients received the vaccines or for which participants it was ineffective. It’s also unclear if the vaccine prevented symptoms irrespective of severity or whether any of the participants had underlying conditions. To quote one commentator, “all we have right now is a headline by Pfizer”.
There have been false alarms even as recently as this year. At one point this year, early positive news about Gilead’s remdesivir, the first treatment to be approved for COVID-19, added approximately U.S $15.7 billion to the company’s market capitalisation. In the third quarter of 2020 alone, sales of remdesivir earned Gilead U.S $873 million. But in October, data from the largest scale remdesivir trial to date by the WHO showed the drug had no meaningful impact on survival. The WHO has now issued a conditional recommendation against the use of remdesivir in hospitalized patients, regardless of disease severity.
Lack of comprehensive data is not by itself an indictment of the effectiveness of the vaccines currently in development. But it does suggest the need for caution. Both Pfizer’s and BioNTech’s stock prices have soared, with Pfizer’s shares following the announcement hitting a 52 week high. Over at BioNTech, early investors are believed to have added USD $8 billion to their wealth as a result of the announcement. A similar story has played out for Moderna. Upon release of their press statement, shares in Moderna jumped nearly 16 percent (only to drop 5.2 percent the next day when a BMO Capital analyst recommended “taking some profits”). Moderna’s company executives have already made tens of millions of dollars by cashing in stock after the release of its positive — but highly limited — data in September. Meanwhile, public money has been central to driving much of this perceived progress. BioNtech received more than USD $400 million from the German government and the U.S government has already committed nearly $U.S 2.5 billion toward the development and purchase of Moderna’s vaccine.
We all have high hopes that a safe and effective COVID-19 vaccine will be introduced soon so we can finally put an end to this public health nightmare. But, as the Tamiflu saga shows, blind belief, including by major media outlets, in corporate pronouncements is inherently risky. Pharmaceutical companies have every incentive to boost their share prices on the altar of progress. Without more transparent, timely and objective analysis, there’s no way of knowing — before governments have already dished out billions in taxpayer dollars — whether breakthroughs are based on genuine science or the pharmaceutical industry’s insatiable quest for a quick profit.