A health worker opens a deep freezer during a dry vaccination against Covid-19 in Delhi, January 2.
Photographer: T. Narayan / Bloomberg
Photographer: T. Narayan / Bloomberg
As large countries like the US and China want to vaccinate their populations with fast-approved shots, tens of millions of doses prepared for India are in storage, even though they have been approved for use.
While distribution in other countries began shortly after approval with prices signed ahead of time, New Delhi and Serum Institute of India Ltd. – the largest vaccine producer in the world by volume and The local partner of AstraZeneca Plc – has been hanging out behind closed doors for months and has yet to sign a formal offer agreement. It has failed at least 70 million doses of vaccine, despite the urgent need in a country that has the world’s second largest outbreak.
Photographer: Dhiraj Singh / Bloomberg
Serum billionaire CEO Adar Poonawalla said on Sunday that Indian officials had ‘verbally’ agreed to buy 100 million doses at a ‘special price’ of 200 rupees ($ 2.74) per shot, among the approx. $ 4 to $ 5 price given to the British government. The company then wants to sell vaccines privately to individuals and companies within two to three months.
The Indian government wants to put pressure on Serum to lower its prices, as evidenced by the controversial decision to develop a competitive vaccine developed by a local company that is still recruiting volunteers for final phase testing, according to Abhishek Sharma, ‘ an analyst at Jefferies.
The absence has cost precious time in a country where infections have exceeded the 10 million mark, reflecting the tension between public interest and private profits from pharmaceutical companies that want to recover their pandemic investments quickly.
While richer, developed economies have so far mostly avoided price disputes in their deployment, the question of how much vaccinations should cost amid a pandemic that kills more than 10,000 people every day worldwide is likely to increase as it spreads to the developing world. . .
For Prime Minister Narendra Modi, every penny spent on the price of a vaccine in a country where more than 1.3 billion people live will have serious financial consequences for his government.
“If you buy in bulk, there is obviously an advantage to being able to negotiate the price,” said Randeep Guleria, a member of Modi’s Covid-19 management team and director of the All India Institute of Medical Sciences. said a statement. interview on Monday. He added that negotiations are underway under the procurement policy, and that they will obviously also be able to decide what the market price will be thereafter. ‘
Guleria said the purchase agreement would be signed “now any day”. India is ready to introduce Covid-19 vaccines within ten days of drug regulator approval, Health Secretary Rajesh Bhushan told reporters during a briefing on Tuesday. He did not say whether a price or offer deal had been signed.
It took five to six days before the UK deployed the first jabs after giving emergency nods to the UK Pfizer Inc. and Astra-Oxford vaccines.
‘Bad transaction’
In October, people with knowledge of the matter told Bloomberg that New Delhi had roughly set aside 500 billion rupees for vaccination efforts, which estimates a total cost of about $ 6 to $ 7 per person. A spokesman for India’s health ministry could not be reached for comment.
“The government is not so easily handing over money to the private sector,” said Ramana Laxminarayan, founder of the Center for Disease Dynamics, Economics & Policy, from the capital of India. ‘They’re just good at playing the game because they have budget pressure – bureaucrats. If they have a bad deal, the minister will send them back immediately and say ‘get me a better price’. “
India’s vaccination blueprint states that 300 million people will be vaccinated in the first phase of deployment, starting with health workers, followed by police and soldiers, and then those with co-morbidities and people older than 50 years. it would take three to four months to complete.
Workers transport a temperature-cooled container at Indira Gandhi International Airport in New Delhi, December 22, 2020.
Photographer: Anindito Mukherjee / Bloomberg
Local officials across the country have been asked to compile priority vaccination lists, but according to interviews with doctors and local representatives, preparations appear to be uneven. Some areas are also preparing to administer two different vaccines simultaneously.
Although AstraZeneca’s shot has been tested in global trials and has received an emergency license from British and Indian regulators in recent days, the vaccine developer is based in Hyderabad. Bharat Biotech International Ltd. has not yet begun analyzing Phase 3 test data, but was also controversially granted limited use approval by the South Asian country over the weekend.
“There are several vaccines that are going to be used,” said Amit Thadani, a surgeon at Nirmaya Hospital in Mumbai. “They’re going to assign one specific type of vaccine that can only be used in one district, so if there’s a problem, it’s easy to determine which specific vaccine is causing it.”
Serum, which has an agreement with AstraZeneca to produce at least one billion doses, has already scaled down an initial production target of 100 million by December due to slower-than-expected approvals.
Poonawalla first began publicly debating potential vaccine prices in September, which some health experts saw as part of a lobbying effort.
In Sunday’s interview, Poonawalla was optimistic that a written agreement would be reached within a few days. “We have already packed it, we just have to send it out in trucks across the countries and have it delivered,” he said, referring to the 70 million doses the company has ready to distribute.
‘Urgent approval’
Meanwhile, India’s decision to grant Covaxin Bharat Biotech’s approval, despite a lack of final data on the effectiveness of the test, has fascinated observers. In August, the company’s chairman, Krishna Ella, said at a conference that their vaccine would be cheaper than bottled water, which costs less than half what Serum AstraZeneca’s vaccine provides.
“The hasty approval of Covaxin, even as a backup candidate, is being driven primarily by the Government of India’s commercial considerations,” Sharma, the health analyst at Jefferies in Mumbai, said in a report on Sunday. If Covaxin ‘can show efficacy in the next few months, subsequent vaccines will have to compete on price as well as efficacy.’
The rapid approval of Bharat Biotech may also be due to the fact that India does not want to see just one vaccine manufacturer.
In an echo of a years-long debate over the role of private pharmaceutical companies, there is growing concern that Serum’s position as the sole local supplier of a potentially life-saving vaccine is too strong.
Outside India, AstraZeneca produces only governments and has not yet concluded any private transactions with companies or individuals. Still, within a few months, Serum wants access to the private margin with a higher margin, where he plans to calculate the price of the shot five times, according to the pricing plans shared by Poonawalla.
First Mover
The proposed price of 1,000 rupees per dose is ‘absolute price increase and use of its position as first car’, says Malini Aisola, the co-convener of New Delhi of the All India Drug Action Network, a health dog. “Personally, I do not think they should be approved for private use at this time.”
But for the wealthy in India’s stratified society, it is not an option to wait for the Byzantine public health care system to distribute doses.
According to the lender’s officials, one large private bank is awaiting guidelines on government dates and benchmark prices, making it possible to consider purchasing the vaccines directly from manufacturers.
For now, Serum is still awaiting its first government order. Poonawalla said India must first secure enough vaccines for their needy. “If we were to sell it the way we wanted, it would be logical for some of the most vulnerable people to miss it,” he said.
New Delhi also knows that the vaccine manufacturer cannot easily move the large quantities elsewhere.
“India buys a lot of vaccines from the Serum Institute every year and they know how to play this game,” Laxminarayan said. “India can wait a little longer, but for Serum it is not going to be that easy for them – the government has ways to rely on it.”
– With the help of Ragini Saxena and Suvashree Ghosh