Will 'greedy' pharma get image boost?

As drug companies around the world work at breakneck speed to develop coronavirus vaccines and treatments, there are expectations that the industry, often accused of being brazenly profit-centric, could redeem its reputation by not engaging in price gauging or profiteering and ensuring the eventual vaccines and treatments are widely available, even in poorer countries.         

More than 120 vaccines are under development and nearly as many drugs are being examined, with some of them now entering clinical trials.  

DW spoke to Gerald Posner, an investigative journalist and the author of a dozen books including Pharma: Greed, Lies, and the Poisoning of America, to understand if the coronavirus crisis could really help Big Pharma repair its tarnished image. Below is an edited version of the interview.

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DW: How is Big Pharma responding to the coronavirus pandemic? 

Gerald Posner: There are two views on that. If you're looking at it just from the medicine point of view, meaning are they working hard and fast to get treatments and work towards a vaccine? The answer is yes. So, there is no delay. There are dozens of companies potentially chasing a vaccine and an equal or larger number looking at possible treatments. And they're dusting off their shelves for older drugs, antimalarials and other antiviral drugs that might be adapted, particularly for SARS-CoV-2. So, I think that they are good on that.  

But, they are for the most part, a for-profit business and we as reporters, journalists and government leaders, should keep an eye on the eventual control of the patents, the intellectual property and the pricing so that the drug companies don't use it as an opportunity for excessive profits. And on that count, they [pharma companies] aren't doing quite as well. But it's too early to draw a final conclusion. 

DW: Pharmaceutical companies, especially the big ones, have often been targeted for being greedy and profit-centric. Do you think they are doing enough during the current crisis to reset their reputation? 

Posner: No. As a matter of fact, I see evidence to the contrary. For instance, CEPI [Coalition for Epidemic Preparedness Innovations], the coalition for epidemics out of Norway, has tried to have an agreement that all the research on any of the vaccine work that they fund will be shared research.

So, no one will own the intellectual property rights to it. But not every drug company has agreed to that. It's a problem for them and it's a problem also in the EU where I know the desire is to have the information shared. But, you know, it's hard to convince. For instance, can the French government really convince Sanofi to do that or, in the case of Bayer, could Germany be able to get them to share all their breakthrough work? I'm just not sure that's possible.  

The other thing is that some of the companies are very smart in terms of public relations. So, Johnson & Johnson and GlaxoSmithKline, one American and one UK company, they have said that they will produce the vaccine for the initial inoculations at cost. Now, if you look at that, you think that's fantastic.

My goodness, you know, they're doing something philanthropic almost. Well, if you look at the small print on that offer, the initial rollout for the health care workers, the frontline people, those in the hospitals and those most at risk, like the elderly, the several hundred million doses that will come out may be at cost. But eventually we will need a minimum of one billion to two billion to get herd immunity in the world.  

The companies are also looking at booster shots down the road. They also expect governments to stockpile the vaccine in case there's another outbreak. So, they are looking for profit, but they're making it look as though they're giving it at cost. You always must look behind the good intention, because it's a for-profit business. Many of them are public companies. They have to serve shareholders and they are looking to make as much as possible on this without getting people so angry that they cause an uproar against them. 

DW: Do you notice any change in the way these big pharma companies are viewed by the general public or by people like you? 

Posner: I saw an opinion poll in the US recently that showed that they were being held in slightly higher esteem than they had been in the past. It's not a dramatic change but I believe that that uptick in public positive view also reflects hope that there will be a vaccine or treatments very soon.  

I do know that after World War II, when the American pharmaceutical companies produced penicillin, which was new to the world, in record amounts and saved a lot of lives on the battlefield as well as a lot of civilian lives. In the 1950s, the pharmaceutical industry was held in very high regard because they had come out of a public effort where they really were viewed as scientists dedicated to healing.  

Since then, there have been many instances, especially in America, where they have been unrestrained, instances of greed and bad drugs. So many that it overshadows the good ones and the good intent and the good researchers. I think they are very low, mostly in public esteem.  

This pandemic is an opportunity for them not just to make money, but also to rehabilitate the public perception of the industry a little bit. If they were able to come up with effective treatments and vaccines at reasonable prices, and they made them available for developing nations as well and helped in the distribution of them. I think a lot of people, including me, would say: All right, they've really stepped up to the plate. They've really done something fantastic at a time when the world has faced a once in a generation public health crisis. I don't know if that will happen, however. It's not in their DNA. 

DW: There are some suggestions of patent-free vaccines for COVID-19. Is it realistic?  

Posner: Look, there was no patent on penicillin, which meant nobody owned it. As a result, after World War II in the 1950s, the price of penicillin dropped very, very low. The companies did not make much money on it. So, what they did was to come up with knock offs of different types of antibiotics. They came up with, you know, streptomycin, and other types of antibiotics. They ended up getting patents on those and they made their money.  

So, if we told the pharmaceutical companies that you will have to share the research on COVID-19 vaccine or treatments and that there will be no patent on them, then they could still make money on other drugs. But, I think that's not going to happen and I say that to you with some distress. There is no government, be it Angela Merkel, Boris Johnson, Macron or Trump, which is going to say: We're going to take the drugs that you develop and distribute them by the government at cost.  

What I do think they could do, but they don't seem to have the political courage to do is to say the governments are funding your research, we're providing billions of dollars. And if, in fact, it's your research that produces a successful vaccine, then some of the money from your profits must come back to the public so that they can use it for additional medical research in the future. Right now, we give it to them, and they make all the money.  

DW: I also want to touch on the issue of vaccine nationalism as we have seen in the case of Sanofi. How do you think the pharmaceutical companies should respond to this? 

Posner: Well, I would hope that the pharmaceutical companies resisted. I don't know if they will. If Sanofi was receiving American funding and said some of the vaccine would first go to America. I understand Macron saying: No, you are a French company and it will be distributed here first. If Trump says, it's America first, and an American company makes the vaccine and he has it distributed first in America. These are very difficult decisions.  

The best way, of course, to do this would be to have a situation in which the pharmaceutical company that made the vaccine, no matter which country it was in, send the first 100 million, 200, 300 million doses that may come out as a batch not only to the country where it is based, whether it's America, Germany, France or China, but also to other countries, to first-line responders, to the people who are working in the emergency room, the doctors who are understaffed, the nurses who are there, to those who are most at risk in the elderly populations.

We should show that this is an international disease and that this virus makes no discrimination upon borders. It doesn't care if you're earning 20 dollars a year and barely having clean water in Somalia or if you are a billionaire in New Delhi living in a penthouse. I would hope that governments in understanding that, would allow drug companies to have an international process. Nationalism is the last thing we need.