Each advance purchase of millions of doses of vaccines by any country or region is an action that is advertised with great fanfare. High hopes are placed on these preventive treatments and guaranteeing the population that they will be able to count on their dose in the future has become an important political asset around the world. In this sense, the European Union (EU) announced about a month ago that it had secured the purchase of 300 million vaccines (expandable to 100 million more) from AstraZeneca. Pre-contracts have also been signed with four more pharmaceutical companies that are evaluating their vaccines in clinical trials: 225 million doses to CureVac, 200 million to Janssen (expandable to 200 million more), 300 million to Sanofi-GSK and 80 million to Moderna. In total, the EU will have at least 1.1 billion doses of vaccines, as long as all these vaccines demonstrate safety and efficacy, something that is by no means guaranteed.
The COVID-19 vaccine will be up to ten times more expensive depending on the pharmaceutical company that makes it
The great media coverage of the acquisition of vaccines by European states contrasts with the secrecy surrounding the negotiations and contracts signed between the European Commission, the states and the pharmaceutical companies. The details of the agreements, the people in charge of negotiating with the pharmaceutical companies and the negotiation processes are, until now, confidential. They are so unknown to such an extent that not even the European Parliament knows the conditions under which vaccines will be purchased.
Last Tuesday, September 22, MEPs of the Public Health Committee of the European Parliament requested more transparency in the purchase of vaccines against the coronavirus. This appeal took place during a joint meeting between European parliamentarians, the European Medicines Agency (EMA), Doctors Without Borders and the pharmaceutical companies Sanofi-GSK and CureVac (Astrazeneca declined to participate) under the title: “How to ensure access to vaccines against COVID-19 for inhabitants of the EU: challenges in clinical trials, in production and in distribution “.
This lack of transparency between states and pharmaceutical companies is not an isolated event, but is the norm in most countries. In Spain, for example, the criteria used by the Interministerial Drug Price Commission to set the prices of prescribed drugs are unknown. These details are confidential and the negotiation processes between the pharmaceutical industry and the Spanish public health administrations they are opaque.
What are the consequences of secrecy in the purchase of medicines? In the first place, this lack of transparency does not allow the public and the experts to know if the prices and conditions of the contracts have been fixed correctly and honestly. On the other hand, the fact that the details are not made public favors the introduction of higher prices for medicines because it hinders competitiveness. In practice, this leads to different prices because hospitals, autonomous communities or countries (depending on each case) do not know the price of the drugs set for others. In addition, the pharmaceutical industry tends to “inflate” its R&D expenses for drugs to gain more power when negotiating with administrations and thus expand its profit margins (higher than in practically any other sector).
Doctors Without Borders has recently published a statement requesting that all EU states adhere to the initiative of the World Health Organization (WHO) to ensure the equitable and fair distribution of COVID-19 vaccines around the world. They also state in said statement: “Full transparency should be required from corporations to reveal R&D and production costs, prices in all countries, the status of intellectual property and licensing and technology transfer agreements. The responsibility rests with this Parliament to ensure that all funding, advance purchase agreements and contracts are publicly available. Business secrecy and privilege should not stand in the way of responding to this global health crisis. ”
The OMS has also been requesting for years greater transparency in different facets of the pharmaceutical industry, such as clinical trials, the different factors that determine the price of drugs or patents. In August, Italy was the first country in the world to take decisive action on this matter. As Belén Tarrafeta, an expert pharmacist in health management and access to medicines, explains, this country “published a decree that obliges the pharmaceutical industry to have total transparency so that its medicines enter the package of medicines that are reimbursed by public health. This implies investments in R&D, public funds received, marketing expenses, profits, prices negotiated for other countries, publication of data, etc. “.
Tarrafeta explains that “very little is known about prices and nothing about prepayment conditions, nor what happens if a vaccine fails. It is also not clear how the quantities and delivery deadlines will be met. All of this is essential to make plans and strategies. vaccination, if there is a vaccine. And to increase the confusion we have bilateral negotiations on the one hand and multilateral negotiations through COVAX on the other, without it being clear to us whether the interests of some collide with the others, and what negotiation will prevail in the event of supply problems. ”
Also, details about the possible compensation that the states will assume to help pharmaceutical companies If unwanted or unexpected effects appear from coronavirus vaccines after they are marketed, they are not public either. And the EMA acknowledged on September 22 that, until that day, this institution had not received any data on the results of the clinical trials of the COVID-19 vaccines and that its process to review the vaccines will begin when they have these data from clinical trials. This agency added that when a vaccine is authorized or withdrawn in the EU, information about this product with anonymized data will be published within three days.
The identity of the people in the European Commission who are negotiating with the pharmaceutical industry the conditions of vaccines is also practically a mystery. Only the identity of one of the seven individuals involved has been revealed, thanks to the Belgian newspaper investigation HLNRichard Bergström, co-owner of pharmaceutical company PharmaCCX, involved in companies that provide services to multiple multinational pharmaceutical companies and CEO of the European innovative pharmaceutical industry employers for years. Neither the questions of the press nor those of the parliamentarians on who are the other six people who are negotiating contracts on vaccines against coronavirus have managed to get the European Commission to make this information public. On the other hand, the Dutch newspaper Algemeen Dagblad reported that the European Commission is forcing member states to keep vaccine procurement contracts secret.
The NGO European Corporate Observatory, whose objective is to show the effects of lobbies corporations in the political decisions of the EU, has made two Freedom of Information requests to the European Commission to publish the data on the negotiations and pre-purchase agreements for COVID-19 vaccines: “We have requested access to contracts for vaccines and asked to receive all correspondence and minutes of meetings between EU negotiators and pharmaceutical companies. ” On October 6, 2020, the deadline for the European Commission to respond to said NGO ends.
As Belén Tarrafeta points out: “The lack of transparency about contracts and prices is nothing new. But the circumstance that aggravates the negotiation around the COVID vaccine is the huge amount of public money injected into the development of the vaccine and in increasing the manufacturing capacity. It seems legitimate to expect that the results of this investment, including scientific and technological knowledge, in addition to the possible vaccine, will be in the public domain. And the minimum to be expected is clarity and transparency regarding the contracts related to a vaccine that, if finally it is achieved, it will be thanks to all “.