How does the COVID-19 pandemic impact the pharmaceutical industry and the drug pricing debate? In the short term, it may have caused a temporary break in the drug pricing media deluge, but it likely will create questions about a new vaccine’s affordability and its ability to reach a broad patient population. As the disease’s spread continues to dominate the world stage, many pharmaceutical companies and university laboratories are working hard to identify treatment and vaccination options for COVID-19.
At least one vaccine candidate has begun clinical trials and a few others aren’t far behind. Hopefully at least one of the them will prove to be active in the prevention of COVID-19 infections. In addition, President Trump put his stamp of approval on an emergency coronavirus aid package that will allocate $3 billion to vaccine research and may further help to accelerate vaccine development. In the current drug pricing environment, early talk of a potential vaccine’s affordability is both not surprising and concerning but the last thing we want to do is add to the scientific hurdles that the medical/pharmaceutical community is facing in developing vaccines and treatments for COVID-19.
Hopefully, the pharmaceutical industry will be able to develop a vaccine for COVID-19 in the shortest possible timeframe. Even with a speedier than normal invention-to-market timeline, any vaccines that are developed probably will reach the market during a future outbreak rather than during the current pandemic. We have learned from the recent re-emergence of measles that population-wide vaccination is essential for highly contagious diseases, so that those too young or immunocompromised to be immunized are protected by herd immunity. Affordability of any vaccine is crucial as overcoming the cost-related hurdles of vaccination is not only in the interest of uninsured patients and insured patients with high co-pays, but also is essential to the population-wide effectiveness of an immunization campaign.
Given the focus of many competing companies on finding a vaccine, multiple versions of a vaccine are likely to appear within a relatively tight timeframe when the scientific challenges are addressed. The market will then balance supply and demand. Private and government insurers should think carefully about what they can do to eliminate access hurdles for a COVID-19 vaccine. Here is where a Netflix-type model could be helpful, in which patients within a country or managed care population are given unlimited access to a medication in exchange for a flat fee to the pharmaceutical company. Patients in Australia, for example, were granted population-wide access to (now four) hepatitis C drugs for a fixed annual sum. Hopefully the US government can play a role in eliminating formal pricing hurdles (such as Medicaid best price and Medicare ASP-plus pricing regulations) that currently stand in the way of adopting a Netflix-inspired payment model and other similar solutions that both payers and the industry embrace.
The COVID-19 pandemic has highlighted the need to maintain a high level of scientific expertise and pharmaceutical capability. Perhaps once the COVID-19 crisis has been contained, there will be an opportunity to initiate some constructive dialog to resolve patient affordability issues for much needed prescription drugs.