If the coronavirus crisis is described by the media as “an unprecedented crisis”, for scientists it is not. They knew that a new pandemic would emerge one day. It was only a matter of time. We were not sufficiently prepared to fight it and to mitigate the consequences we face today.
Investments in research into a vaccine and treatment against coronaviruses came too late, costing hundreds of thousands of lives today. COVID-19 makes it clear that our traditional model of medicines development is not fully in line with the real needs of public health. But alternative models are possible and necessary.
This week, EU policymakers, researchers and other players from across Europe are discussing the EU’s research policy at the Research and Innovation Days conference organised by the European Commission. With the pandemic still ongoing, it couldn’t be a better moment to look at different ways of financing biomedical innovation. Here is how.
Switching the R&D mindset from reactive to proactive
Although this coronavirus outbreak is not the first of its kind, treatments and vaccines to fight viruses are rare. Governments, public research organisations and charitable funds mainly invest in research against infectious diseases during a pandemic. Once it is under control, investments fall (too) sharply.
If pharmaceutical companies are reluctant to invest in research to treat infectious diseases, it is because of their “uncertain” nature. Indeed, betting on a potential epidemic is less profitable for the pharma industry than developing ‘bankable’ drugs, such as medicines to treat cancer and rare diseases. In addition, as epidemics most often break out in underprivileged countries, it is unlikely pharma companies will profit much from drugs to fight them.
betting on a potential epidemic is less profitable for the pharma industry than developing ‘bankable’ drugs
However, from a public health perspective, investments in emerging infectious diseases are useful and necessary. As we write these lines, almost one million people have died due to a SARS-CoV2 infection worldwide. From an economic point of view too, it is in the interest of the community to protect itself from a possible pandemic. Just look at the costs of the current crisis. If we look at where I live, the Belgian economy is heading towards a 10.6% decrease this year, the biggest ever since WWII.
The current COVID-19 pandemic demonstrates that society should no longer think in terms of individual epidemics. It is necessary to be proactive rather than reactive to avoid being trapped again next time.
Publicly funded medicines must be affordable
The race for a vaccine is on, now that we are in the middle of the pandemic, pulling considerable public investments. Together, the European Commission, several Member States and philanthropic funds have pooled billions of euros for the research and development of a vaccine and treatment against SARS-CoV2. Whilst this is good news, too often research is being carried out without enough guarantees that the final product will be accessible to all.
We have seen this already in the case of remdesivir, the first medicine approved to treat SARS-CoV2. Whilst the development and the studies conducted to test this drug as a COVID-19 treatment were partly financed with public money, the pharmaceutical company that owns it, Gilead, is charging a very high price for the drug. The EU placed this summer a limited order of remdesivir to treat an estimated 30,000 COVID patients, for which Gilead invoiced €63 million, i.e. €2,100 to treat one patient. This price is well above cost recovery and anything but a fair profit margin.
That is precisely why public investments into the development of vaccines and treatments must be subject to the condition that, once developed, the products will be available and affordable to those who need them, thus saving lives.
It is high time for the EU and Member States to support greater research into diseases neglected by the private sector. To maximise public return on investment, they must ensure that consumers and healthcare systems do not foot a high bill for medicines they have paid to develop.
Only by prioritising public health needs and ensuring that medicines are affordable we will be able to respond effectively to the COVID-19 pandemic. And future crises.
Martine Van Hecke, is Health Expert at Belgian consumer group Test Achats/Test Aankoop.
In November 2018, Test Achats–Test Aankoop organised the symposium “Accessibility and development of medicines” with NGOs Médecins du Monde and Kom op tegen Kanker. The event focused on extremely high drug prices and unmet medical needs. The three organisations came up with 10 proposals for a new medicines policy. More information on https://www.medicamentstropchers.be
 In 2003, another type of coronavirus spread from China. The virus, called SARS-CoV, caused serious respiratory problems and affected more than 30 countries on five continents. Ten years later, another outbreak of a related virus (MERS-CoV) surfaced in the Middle East and led to several outbreaks in 27 countries. Both viruses are on the World Health Organization’s list of priority pathogens for research. Neither of these two viruses currently has a vaccine or medical treatment with proven efficacy.