The Covid treatment pill is here – and Big Pharma will ultimately decide who gets it | Ottoman Mellouk
Covid-19 has quietly become the gift given to big pharma over and over again. Over the past two years, it has made huge profits on Covid vaccines while opposing wider sharing of the technology needed to manufacture them. And now a new hit is on the rise: antiviral Covid pills for treatment. Once again, we are poised to fall into the same inequality traps we fall into when vaccines are rolled out globally.
Both Pfizer and Merck are fast rolling out new antiviral pills –– Paxlovid and Molnupiravir, respectively. As with the vaccines that came before them, both companies have made it their mission to ultimately decide who gets to make generic versions through the medical patent system — a crucial, life-saving issue for millions of people around the world.
And the business certainly looks promising. Pfizer alone, freshly cemented as the global Covid-19 vaccine kingpin, expects to make as much as $22 billion this year from its new pill, on top of the $37 billion it will make from the vaccine in 2021 Has.
The new drug is not cheap. Pfizer’s Paxlovid currently costs about $530 for a five-day treatment cycle. Merck’s molnupiravir, now approved in the UK, costs around US$700. The reported production cost of molnupiravir is approximately $17.74.
Familiar alarm bells should ring. Experts across the board are predicting that demand for antiviral drugs will quickly outstrip supply. A World Health Organization report produced in January warned of a “high risk of shortages” of Paxlovid for low- and middle-income countries until generic versions become more widely available, which likely won’t be until the second half of 2022 at the earliest. A separate analysis by data and analytics firm Airfinity suggests that could be the case as early as early 2023. After uneven global vaccine rollout, even low-income countries are faced with the prospect of a “wild west” scenario for life-saving pills.
Pfizer and Merck have chosen to use the Medicines Patent Pool (MPP) to designate a few generic drug companies that are able to produce cheaper versions of their drugs. But even with those agreements, they retain full control, and access to generic versions is just within reach half of the world population.
A number of countries, including Argentina, BrazilThailand, Russia, Colombia, Peru, Turkey and Mexico have again been barred from such licenses and must attempt to close bids on the most expensive products. With so many priced out by the market, global supply is once again prioritized for rich countries, while companies refuse to make affordable generic antivirals available to everyone, wherever they are needed.
This is a grim reflection of the dramatically uneven vaccine supply early in the pandemic, when wealthy nations bought far more doses than they could use. The US, where almost two-thirds (65%) of the population is already fully vaccinated, reportedly has more than 10 billion same protection. For less affluent nations, competition is not even a possibility.
Meanwhile, Merck is continuing its “evergreen” patent strategy to extend its monopoly on molnupiravir beyond the standard 20-year protection. Since the pill‘s development, the company has filed at least 53 patent applications to keep it within legal bureaucracy and control over who gets to make it and where. It has already received emergency use approval in the US and Japan and has been given the green light in the UK.
Even in countries within the MPP where the pills are allowed to be manufactured by selected manufacturers, a low price is not guaranteed. dr Reddy’s Laboratories in India has made a generic version of Merck’s pill that costs $18 for one treatment. However, these costs will not necessarily be reflected everywhere. Across the border in Bangladesh is the generic version of Pfizer’s pill more than $170 for treatment – prohibitively expensive for a large part of the population. By restricting which manufacturers can produce a generic version, companies retain considerable control over the final price. In the past, the price of Gilead’s hepatitis C drug, sofosbuvir, has steadily declined only as the number of manufacturers without those restrictions has increased.
There is an uncomfortable assumption that those in the Global North have begun to tacitly accept. When demand is greater than supply, there is a pecking order: the rich nations first buy up more than they realistically need, while the poorest are forced to outbid each other with what is left, dramatically overpaying or just wait until they are affordable and see the death toll soar. But this supply crisis is entirely artificial. We could produce more – Pfizer’s and Merck’s drugs are not complex and could easily be manufactured in a large number of developing countries if they had access to the know-how and could avoid the threat of legal action. We must eliminate patents and other intellectual property barriers to life-saving medicines – either voluntarily by companies or by government regulation – so that we can quickly deliver to every country in the world.
When it comes to Covid-19, we lean on a world divided in two – rich, heavily vaccinated nations with easy access to preventive measures and treatments, and poorer nations trying to get by without either. It’s important that we don’t sleepwalk and give corporations so much control over who stays alive and who dies, all balanced with what they think is an acceptable end result.