How Pfizer Won the COVID Pandemic With Vaccine, Booster, and Paxlovid

By Arthur Allen | KHN

Two additional years of the pandemic have brought enormous benefits to one company—Pfizer—Make it both impactful and profitable as covid-19 continues to infect tens of thousands of people and kill hundreds every day.

Its success in developing covid drugs has given the drugmaker unusual weight in determining US health policy. Based on internal research, company executives have regularly announced the next phase in the fight against the pandemic before government officials have had time to research the issue, making it difficult to many medical professionals and leaves some patients uncertain who to trust.

Pfizer’s 2021 revenue is $81.3 billion, nearly double its revenue in 2020, when its best-selling products are the pneumonia vaccine, the cancer drug Ibrance, and the drug treatment. fibromyalgia Lyrica, out of patent.

Currently, its mRNA vaccine accounts for 70% of the US and European market. And its antivirals Paxlovid is the pill of choice to treat the initial symptoms of covid. This year, the company is expected to rake in more than $50 billion in global sales from just these two drugs.

Paxlovid’s value to vaccinated patients remains unclear, and Pfizer’s covid vaccine does not completely prevent infection, although each booster dose temporarily restores some protection. However, even though patients can recover when repeat injections are needed – the two boosters are currently recommended for people aged 50 and over – the claim is gold for investors.

“Hopefully we can award it annually and maybe to some high-risk groups more often,” Chief Executive Officer Albert Bourla told investors this year. “Then you have the treatment [Paxlovid] That would, say, solve the problems of people who are sick. “

President Joe Biden listens as Pfizer CEO Albert Bourla speaks ahead of the G7 summit in 2021.

Brendan Smialowski / AFP via Getty

Just Wednesday, the Biden administration agreed to buy an additional 105 million doses of Pfizer’s covid vaccine for the fall campaign boost, for $3.2 billion. At $30.47 a dose, that’s a significant premium compared to the $19.50 a dose the government paid for the first 100 million. Vaccines are being modified to target early omicron variants, but newer variants are dominating.

Because the virus is constantly mutating and will persist for a long time, the market for Pfizer products is not going away. In richer countries, the public tends to keep coming back for more, like diners at an all-you-can-eat restaurant, having eaten their fill but never completely satisfied.

Reliance on Pfizer products at each stage of the pandemic has fueled the US response, including in critical public health decisions.

Last year, when Bourla suggested that a booster shot would soon be needed, US public health officials later followed suit, creating the impression that Pfizer was calling the tune. Some public health experts and scientists worry that these decisions are hasty, such as noting that although boosters with mRNA injections created by Moderna and Pfizer-BioNTech help improve improves initial antibody protection, but it usually does not last long.

Since January, Bourla has said that all U.S. adults will likely need an annual booster shot, and senior FDA officials have indicated they agree since April.

At a June 28 meeting of FDA advisers to consider a potential fall vaccination campaign, Pfizer presented studies involving about 3,500 people that showed tweaks to the covid vaccine. allowing it to produce more antibodies against the omicron variant that began circulating last December. But most advisers say the FDA should require the next vaccine to target an even newer omicron variant, called BA.5.

That means more work and expense for Pfizer, the company has called on the FDA to allow it to make future changes to the covid vaccine without human trials — similar to how the annual flu vaccine is approved. “If such a process were to be implemented, the response to future waves could be dramatically accelerated,” said Kena Swanson, Pfizer’s vice president of viral vaccines.

FDA officials at the meeting did not immediately respond to the request.

As societies forgo other efforts to control the spread of covid, such as the mandate to wear masks and physical distancing, Pfizer’s outlook is even brighter, especially now that the public company launched the first oral treatment, Paxlovid.

“People are going to get out there,” Angela Hwang, president of Pfizer Biopharmaceuticals Group, told investors on May 3. “We know with all of that, infections are going to increase and that’s it. the role of Paxlovid.”

A pharmacy manager shows off a package of Pfizer Paxlovid pills.

Chris Sweda / Chicago Tribune via Getty

In a recent investment call, a Pfizer official could turn recent reports suggesting that the virus could be hiding from Paxlovid into good news, predicting that, as with vaccines, disease Patients may need multiple treatments.

Dr Mikael Dolsten said immunocompromised patients “can carry this virus for a very long time. “And we see that area as a real new opportunity development area for Paxlovid to do very well, where you might need to take a lot of courses.”

Pfizer has spent heavily to increase its influence during the pandemic. Since the beginning of 2020, it has spent more than $25 million on internal lobbying and paid out 19 companies to lobby, push for legislation to protect its products and promote programs. stronger vaccination program in the United States.

Pfizer’s donations to political candidates in the 2020 cycle are larger than those of any other drug company, totaling about $3.5 million, with the largest share going to Democrats . Joe Biden received $351,000; Donald Trump is only $103,000.

Unlike Moderna, Sanofi, Novavax and Johnson & Johnson, which receive billions of dollars in US support, Pfizer is not seeking government money to develop its vaccine, saying it will work independently. create.

Pfizer has benefited from the $445 million the German government provided to BioNTech, Pfizer’s partner in vaccine development. And finally, Pfizer relies heavily on the logistical support of the US government, according to one New book by former Health and Human Services official Paul Mango.

Pfizer recorded $7.8 billion in revenue for covid vaccines in 2021. The government has options to purchase 1.6 billion doses of Pfizer vaccine and has purchased 900 million of them to date, including 500 million purchased at a non-profit price to donate to poor countries.

Pfizer’s terms in the contract exclude many taxpayer protections. They deny any government intellectual property rights and say federal spending played no role in vaccine development – even though National Institutes of Health scientists did invent. a key feature of the Pfizer vaccine, said Robin Feldman, a patent law expert at the University of California.

“The deal could set a precedent in which another company could invoke Pfizer contracts to argue that the government has given up all rights to an invention,” she said.

The government has also agreed to buy around 20 million five-day courses from Paxlovid for $530 each.

Bourla said at an event in January, drug and vaccine prices will increase as the pandemic period ends, “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 focused on working collaboratively with all stakeholders to bring the world two medical breakthroughs. In doing so, we moved with scientific speed, adhered to rigorous regulatory processes, and relied on the expertise of our scientists and manufacturing capabilities. “

There is little doubt that the company has disrupted a scientist’s operation in rapidly responding to medical needs caused by the pandemic. It used artificial intelligence to track the spread of the virus and found the best places to recruit volunteers for vaccine trials, and deployed rapid drug-screening tools to detect the virus. Paxlovid development.

Its success with the covid vaccine has raised hopes for a Pfizer vaccine for respiratory syncytial virus, a danger to infants and older adults. The company is also moving towards seeking licenses for shots against Lyme disease and nosocomial infections.

Pfizer has long shunned the vaccine business, with historically modest financial returns. It stopped making human vaccines in the late 1960s after a catastrophic measles vaccine recall, which left many children sick after being exposed to the virus that caused an unwanted reaction to the virus. Antibodies stimulated by injection. The company returned to the field in 2009 when it bought Wyeth, which was making an effective and highly profitable vaccine against pneumonia and ear infections.

Now, Pfizer is a new kind of global power. In 2021 alone, the company employed nearly 2,400 people. “We are a household name to billions of people right now,” Bourla said in January. “People are trusting the Pfizer vaccine.”

The company’s power concerns some immunists, who see its growing influence in a field of medical decision-making traditionally led by independent experts.

During a recent investor call, BMO Capital Markets analyst Evan Seigerman asked if the world is “blindly recommending bullish drugs” too often.

Data from Israel, which used only the Pfizer vaccine and provided most of the studies leading to booster vaccination recommendations from the Centers for Disease Control and Prevention, show that the third and second doses The effect of vaccine mRNA increases antibody levels which rapidly wane again. The added boosters have saved some lives in the population over 60, but the data are less clear on the benefit for young people.

When President Biden in September 2021 delivered boosters to Americans – not long after Bourla suggested them – Dr. Paul Offit, director of the Center for Vaccine Education at Children’s Hospital of Philadelphia and developer of enterovirus vaccines, asked himself, “Where is the evidence you’re at risk for serious illness? in the face of covid if you are vaccinated and under 50 years old? “

Policies on strengthening recommendations for different groups are complex and changing, Offit said, but the CDC, not Bourla and Pfizer, should implement them.

“We are being pushed,” he said. “Pharmaceutical companies are acting like public health agencies.”

KHN (Kaiser Health News) is a national newsroom specializing in the production of in-depth coverage of health issues. Along with Policy Analysis and Exploration, KHN is one of the three main activities in KFF (Kaiser Family Foundation). KFF is a nonprofit organization privileged to provide information on health issues to the nation.

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