Profiteering or Philanthropy? – Pharma’s Role in the Coronavirus Crisis
“Like toilet roll profiteers, some (pharma firms) are failing to share all of the data on potential candidate treatments that they hold … they are keeping it stashed in their digital attics and cellars where others cannot get at it, on the grounds that it is commercially confidential.”
Strong words from leading UK scientist and former UK Health Minister, Professor Ara Darzi. Writing in The Guardian newspaper, Prof Darzi, a surgeon and director of Global Health Innovation at Imperial College London, suggests that leading AI companies now collaborating on crunching the data that might identify successful drug candidates are being hindered because some pharma companies are failing to collaborate in the search for treatments for COVID-19 in the same way they have done for drug-resistant infections.
Without full access to comprehensive data, scientists will be fighting with one hand tied behind their backs, he writes, urging all drug manufacturers to unlock their chemical libraries so that candidate drugs can be identified and clinical trials started as soon as possible.
However, Prof Darzi does acknowledge that companies have been donating medicines, laboratory space, know-how and manpower as well as indicating that they will not enforce patent protection on some drugs.
How Are Companies Responding? To be fair to industry, there is increasing evidence of companies collaborating with each other and with academic researchers and charitable organisations to accelerate development of treatments and vaccines for COVID-19 as well as tests for the virus.
For example, GlaxoSmithKline and Sanofi are collaborating on development of an adjuvanted COVID-19 vaccine, with Sanofi contributing its S-protein COVID-19 antigen and GSK offering its pandemic adjuvant technology. Johnson & Johnson plans to team up with the US government to invest over $1 billion in a new vaccine against COVID-19. MSD is working with the Bill and Melinda Gates Foundation and industry peers to accelerate development, manufacture, and delivery of vaccines, diagnostics, and treatments. Novartis has entered new collaborative research efforts such as the COVID-19 Therapeutics Accelerator, coordinated by the Bill & Melinda Gates Foundation, Wellcome, and Mastercard, as well as a COVID-19 partnership organised by the Innovative Medicines Initiative, an EU public-private partnership that funds research and innovation. Pfizer has outlined a 5-point action plan that includes a commitment to share its clinical development and regulatory expertise to support smaller biotech companies that are screening compounds or existing therapies for activity against the corona virus.
In respect of testing, some companies have been quick to respond to calls for help in developing the antibody/serology tests that will be essential if countries are to find a way out of lockdowns. GSK is working with AstraZeneca on development of such a test and the two companies are setting up a new laboratory for screening for the virus with the aim of carrying out 30,000 tests a day by the beginning of May.
The R&D heads of 10-plus biopharmaceutical companies are reported to have been meeting several times a week to coordinate a joined-up response to the COVID-19 pandemic. This is said to be split into five working groups, focused on clinical-phase repurposing, novel small-molecule antivirals, novel antibodies, preventive vaccines and preclinical repurposing.
Pricing and Patents
Industry’s critics will of course see such moves as efforts to exploit the commercial opportunities from launching products that, if successful, could reap ‘blockbuster’ profits. When such products do reach the market, if they are to avoid charges of profiteering, companies will have to tread very carefully in relation to their pricing policies and how they handle intellectual property.
More than 20 international aid organisations are calling on governments to ensure that COVID-19 vaccines, for example, developed with the aid of taxpayers’ money are produced ‘patent free’, supporting a suggestion from the Cost Rican government for a global ‘patent pool’.
“The UK is putting millions of pounds of public money into global efforts to find a vaccine for COVID-19. This money cannot be handed to pharmaceutical companies with no strings attached … We have to stop putting the economic interests of the pharmaceutical companies above people’s health”, according to Medecins Sans Frontiers UK’s executive director Vickie Hawkins.
Tone of the Debate
If they are to avoid statements such as these setting the tone of the debate, more companies will have to heed advice such as that offered by Daichi Sankyo’s UK Managing Director Manuel Reiberg, who told a recent eyeforpharma meeting:
“As we see increasing pressure on the healthcare system, I believe pharma has to start moving in a more sustainable direction – both when it comes to pricing but also investing in activities to support the healthcare system and reduce inefficiencies.”
Acknowledging the prospect of technological advances improving the efficiency of R&D, Mr Reiberg expressed the hope that industry would be “wise enough” to pass these savings on to payers rather than using them to boost profits.
Striking a Balance
GSK says it will try to “strike a balance between generating an economic return and reinvesting in our business over the long-term, whilst acting with urgency and responsibility to support governments, payers and people.”
GSK will adopt a three-pronged approach: First, it will supply its adjuvant to governments and institutions at a “responsible price”, calculated using inputs including benchmarks to previous H1N1 contracts and the costs for production and development. Second, it will make the adjuvant available to the world’s poorest countries, including donations and by working with governments and global institutions that prioritise access. Third, short-term profits on sales of the adjuvant during the COVID-19 pandemic phase will be invested to support long-term global pandemic preparedness.
Actions Not Words
However, it will be on its actions, not its words, that the industry response to the coronavirus crisis will be judged.
With most of the world in lockdown and healthcare professionals focussed primarily on COVID-19, pharma marketing could almost be considered irrelevant. However, innovative pharma firms still have a major role to play in the healthcare arena. Other diseases apart from COVID-19 need attention, and healthcare professionals still need information on therapeutic advances and support with patient materials.
With field forces out of the game, companies must rely much more on digital channels, accelerating what was already a trend. Decision Resources Group’s latest ePharma Physician report found a drop in the share of US physicians seeing reps in person from 67% in 2018 to 54% in 2019. Doctors cited time pressures as the main reason. The report also finds a rise in the number of physicians who have not communicated with a rep in the previous six months from 24% to 39%, with the percentage of primary care physicians that reported no interaction with pharma reps jumping from 21% in 2018 to 40% in 2019.
Now, with face-to-face contacts discouraged, doctors have been forced into video consultations with patients. Telemedicine is here to stay. Also, large swathes of the population have been quick to adopt video meetings through platforms such as Zoom for both work and leisure. In just a few weeks we have become a much more digitised society. In a post-COVID-19 world, pharmaceutical marketing will no doubt adapt accordingly.