The crushing two years of the pandemic have generated outsized benefits for one company – Pfizer – making it both highly influential and hugely profitable as covid-19 continues to infect tens of thousands of people and kill them. kill hundreds every day.
Its success in developing covid drugs has given the drugmaker unusual clout in determining US health policy. Based on internal research, company executives frequently announced the next step in the fight against the pandemic before government officials had a chance to study the matter, annoying many experts in the medical field and leaving some patients unsure who to trust.
Pfizer’s revenue in 2021 was $81.3 billion, about double its revenue in 2020, when its top sellers were a pneumonia vaccine, cancer drug Ibrance and treatment for fibromyalgia Lyrica, which had lost its patent.
Today, its mRNA vaccine holds 70% of the US and European markets. And its antiviral Paxlovid is the pill of choice to treat the first symptoms of covid. This year, the company expects to raise more than $50 billion in global revenue from the two drugs alone.
The value of Paxlovid for vaccinated patients is not yet clear, and Pfizer’s covid vaccine does not fully prevent infections, although each booster temporarily restores some protection. Yet while patients may balk at the need for repeat injections – two boosters are now recommended for people aged 50 and over – the requirement is gold for investors.
“Hopefully we could give it every year and maybe more often for certain high-risk groups,” CEO Albert Bourla told investors this year. “Then you have the treatment (Paxlovid) which will, say, solve the problems of those who get the disease.”
Just last week, the Biden administration agreed to purchase an additional 105 million doses of Pfizer’s covid vaccine for the fall booster campaign, paying $3.2 billion. At $30.47 a dose, that’s a significant premium over the $19.50 a dose rate the government paid for the first $100 million. The vaccine is being modified to target early omicron variants, but newer variants are gaining prominence.
Since the virus continues to mutate and will be around for a long time, the market for Pfizer products will not go away. In wealthier countries, audiences are likely to return for more, such as all-you-can-eat restaurant dinners, full but never completely satisfied.
Reliance on Pfizer products at every stage of the pandemic has guided the United States’ response, including critical public health decisions.
Some public health experts and scientists worry that these decisions were hasty, noting, for example, that although boosters with mRNA injections produced by Moderna and Pfizer-BioNTech initially improve antibody protection, this usually does not last. .
At a meeting of FDA advisers on June 28 considering a possible fall vaccination campaign, Pfizer presented studies involving about 3,500 people showing that adjustments to its covid vaccine allowed it to get more antibodies against the omicron variant that began circulating last December.
But most advisers said the FDA should require the next vaccine to target an even newer variant of omicron, known as BA.5.
That would mean more work and expense for Pfizer, which has asked the FDA to allow it to make future changes to the covid vaccine without human trials — the same way annual flu shots are approved. “If such a process were implemented, responses to future waves could be significantly accelerated,” said Kena Swanson, Pfizer’s vice president for viral vaccines.
FDA officials present at the meeting did not immediately respond to the suggestion.
Leverage the opportunity
As companies abandon other efforts to control the spread of covid, such as mask mandates and physical distancing, Pfizer’s prospects look even brighter, especially now that the company has released the first oral covid treatment, Paxlovid. .
“People are going to exit,” Angela Hwang, president of Pfizer Biopharmaceuticals Group, told investors May 3. “We know that with all of this, infections are going to increase, and that’s the role Paxlovid can play.”
In a recent investor call, a Pfizer official could turn recent reports that the virus may be hiding from Paxlovid into good news, predicting that, as with the vaccine, patients may need multiple courses.
Immunocompromised patients “can carry this virus for a very, very long time,” Dr. Mikael Dolsten said on the investor call. “And we see this area as a real new growth area for Paxlovid, where you may need to take several courses.”
Pfizer has spent lavishly to bolster its influence during the pandemic. Since the start of 2020, it has disbursed more than $25 million for internal lobbying and payments to 19 lobbying firms, pushing for legislation to protect its products and promote more robust U.S. vaccine programs.
Pfizer’s donations to political candidates in the 2020 cycle were larger than those of any other pharmaceutical company, totaling about $3.5 million, with the largest share going to Democrats. Joe Biden received $351,000; Donald Trump only $103,000.
Unlike Moderna, Sanofi, Novavax and Johnson & Johnson, which have secured billions of dollars in US backing, Pfizer has not asked the government for money to develop its vaccine, saying it will work independently.
Pfizer benefited from $445 million that the German government provided to BioNTech, Pfizer’s partner in developing the vaccine. And, in the end, Pfizer relied heavily on logistical support from the US government, according to a new book by former health and human services official Paul Mango.
Pfizer recorded $7.8 billion in revenue in the United States for its covid vaccine in 2021. The government has the option to purchase 1.6 billion doses of the Pfizer vaccine and has so far purchased 900 million, including 500 million purchased at non-profit prices to be donated to poor countries.
Pfizer’s terms in the contracts exclude many taxpayer protections. They deny the government any intellectual property rights and say federal spending played no role in vaccine development — even though National Institutes of Health scientists invented a key feature of Pfizer’s vaccine, Robin Feldman says , an expert in patent law at the University of California.
“The deal could set a precedent,” in which another company could cite Pfizer contracts to argue that the government waived any right to an invention, she said.
The government also agreed to buy about 20 million five-day courses from Paxlovid for $530 each.
Prices for the covid drug and vaccine will increase once the pandemic period is over, Bourla said at an event in January, “to reflect cutting-edge technology.”
Pfizer spokeswoman Sharon Castillo declined to answer specific questions about Pfizer’s influence on pandemic policy. She released a statement saying that “Since day one of this pandemic, we have been laser focused on working collaboratively with all relevant stakeholders to bring two medical breakthroughs to the world. In doing so, we have moved at the speed of science, complied with stringent regulatory processes, and relied on the expertise and manufacturing prowess of our scientists.
There is no doubt that the company has pulled off a scientific home run by responding quickly to meet the medical needs created by the pandemic. It used artificial intelligence to track the spread of the virus and find the best places to recruit volunteers for its vaccine trials and deployed rapid drug screening tools to develop Paxlovid.
Its success with the covid vaccine raised hopes for a Pfizer vaccine against respiratory syncytial virus, a danger to babies and the elderly. The company is also moving toward licensing vaccines that protect against Lyme disease and hospital infections.
Pfizer had long shunned the vaccine business, with its historically modest financial returns. It abandoned human vaccine production in the late 1960s after the recall of its disastrous measles vaccine, which sickened dozens of children after exposure to the virus and caused unexpected reactions with antibodies boosted by the measles. vaccine. The company returned to the field in 2009 when it bought Wyeth, which made a highly effective and exceptionally cost-effective vaccine against pneumonia and ear infections.
Today, Pfizer is a new kind of global powerhouse. In 2021 alone, the company hired nearly 2,400 people. “We’re a household name right now for billions of people,” Bourla said in January. “People trust Pfizer vaccines.”
The power of the company worries some vaccinologists, who see its growing influence in an area of medical decision-making traditionally led by independent experts.
On a recent investor call, BMO Capital Markets analyst Evan Seigerman asked if the world “goes blindly recommending boosters” so often.
Data from Israel, which uses only Pfizer’s vaccine and provided most of the studies that led to vaccination booster recommendations from the Centers for Disease Control and Prevention, suggests that the third and fourth doses of the vaccines at mRNAs increase antibody levels which quickly decrease again. Adding reminders has saved lives in the over-60 population, but the data is less clear about the benefits for young adults.
When President Biden in September 2021 offered reminders to Americans — shortly after Bourla recommended them — Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and developer of a vaccine against a intestinal virus, wondered: “Where is the evidence that you are at risk of serious illness when you are confronted with covid if you are vaccinated and are under 50? »
Policies on recall recommendations for different groups are complex and changing, Offit said, but the CDC, rather than Bourla and Pfizer, should make them.
“We are pushed,” he said. “Pharmaceutical companies act like public health agencies.”
Kaiser Health News is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the Kaiser Family Foundation’s three major operating programs. KFF is an endowed non-profit organization providing information on health issues to the nation.