Usually, in true capitalist tradition, pharmaceutical companies compete with each other. Clinicians routinely encounter salespeople from different companies with products for the same condition. Often they directly compare competing drugs with their own, pointing out advantages and disadvantages.
Yet, vaccine development during the ongoing COVID-19 pandemic tells the other side of the story. Pharmaceutical companies also have a tradition of collaboration. Just days ago, in a deal overseen by the White House, Merck & Co announced that it would help manufacture the new Johnson & Johnson coronavirus vaccine.
Because pharmaceutical companies have shared interests in how the public and the government see the industry as a whole, it often results in cooperation rather than competition. One key example is how pharmaceutical companies collaborate with each other in their political lobbying efforts, all of them contributing to a single organization called PhRMA.
Another is found in the consortia aimed at defining how drug studies are conducted, such as for new or different indications or endpoints. These consortia, which often include academic researchers, enable companies to agree with each other about which diagnoses or endpoints to use. This, in turn, allows them to influence or be influenced by the larger academic community in order to reach a consensus on such topics, which can give them much more influence on government regulations.
Government regulations exist not only at the margins of the pharmaceutical industry but centrally in the day-to-day work of drug sales and development. For instance, the drug marketplace is significantly impacted by patent laws, which are decided by the government. Pharmaceutical companies also negotiate prices with government health insurance; there's no real supply-and-demand process for pricing. The importance of government regulations is reflected in how sensitive the pharmaceutical industry is to its public image.
COVID Cooperation
To date, most of the coronavirus vaccines that have been developed — or that are in development — have been created by small biotechnology companies whose total workforce is a fraction of those of their larger pharmaceutical peers.
Given their size, these companies have little to no capability to produce or distribute drugs. The larger pharmaceutical companies are needed as their collaborators to ramp up production and distribute drugs. For example, BioNTech created the first COVID-19 vaccine and Pfizer is distributing it, yet they are unable to meet demand for a product that literally requires distribution to the entire world. The second vaccine, produced by the small biotechnology company Moderna, is also limited, as it is not partnering with a larger pharmaceutical company.
Given the current delays in production and distribution, other large pharmaceutical companies have stepped up to offer their assistance. Sanofi has a large vaccine production capacity, and it will now produce the BioNTech/Pfizer vaccine. Other companies have also offered to use some of their factories and distribution services to produce current vaccines, including, as mentioned, Merck, in helping produce the Johnson & Johnson vaccine.
There is no immediate benefit to these other companies to produce the vaccines of a competitor, and it's possible that at least some won't receive any profit for doing so. But the worldwide pandemic does not discriminate among businesses. As for all companies and all economies, it is in the interest of the overall pharmaceutical industry for the pandemic to end as soon as possible, thus giving these companies another overriding shared interest.
By producing and distributing competitors' vaccines, companies are helping themselves indirectly. This shared interest, of course, overlaps with the public health, since ending the pandemic is in the interest of all human beings everywhere in the world.
One of the lessons of the pandemic is that we all are in this crisis together. Years ago, Martin Luther King, Jr repeated this point over and over again, saying that we are all caught in an inescapable network of mutuality, and that what hurts one of us hurts us all.
Too often we think of each interest group competing with another; indeed, the private capitalist system is based on this principle. But in some ways, this capitalist concept doesn't apply to modern society, with all of its government regulations and functions. And it certainly doesn't apply in an international medical crisis, where we all rise or fall together.
Nassir Ghaemi, MD, MPH, is a professor of psychiatry at Tufts Medical Center and a lecturer in psychiatry at Harvard Medical School. He is the author of several general-interest books on psychiatry. He is employed currently at Novartis Institutes for Biomedical Research in Cambridge, Massachusetts. The views expressed here are his own and do not reflect those of his employers.
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Cite this: Big Pharma Is Collaborating on COVID-19 Vaccines, and Here's Why - Medscape - Mar 12, 2021.
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