The Big Pharma Conspiracy: Are they out to get us?

Having done so much research on the flu vaccine for other posts, I have learned a lot about the science and technology that goes into the flu vaccine every year. I have talked at length about the makeup, effectiveness and target demographics of the flu vaccine, judging whether it really protects us from the influenza virus. 

Now that we have covered all that, I’d like to delve into a more sensitive social topic that surrounds the flu vaccination, and that is whether or not pharmaceutical companies sell vaccines with the best interests of the public in mind, or if they are just out to make a profit.

It is no secret that U.S.  pharmaceutical companies have sweet talked doctors into prescribing their drugs. A story done by National Public Radio entitled “Dollars for Docs” covered this topic by interviewing Matthew Webb, a drug representative in the 1990’s who was accustomed to “entertaining doctors two or three nights a week” with fancy dinners and sports tickets in order to persuade them to buy his product. 

This was a common and accepted practice until 2002, when the “Code on Interactions with Healthcare Professionals” was published by PhRMA, the pharmaceutical industry’s trade group, effectively outlawing this bribery.
 

So, the question remains: Are pharmaceutical companies producing the flu vaccine for their own profit?

An article in the magazine of Johns Hopkins Bloomberg School of Public Health would suggest that this is not true. In fact, the article states that the production and distribution of vaccines is so unprofitable for drug companies that most seem to do it out of sheer goodwill towards the community. Citing a $300 to 400 million dollar start-up price for any vaccine, the article states that the costs of manufacturing have actually discouraged most drug companies from producing them at all.

After this huge initial investment, the Johns Hopkins article also states that drug companies have a lot to do before they can actually administer their vaccine to the public. Due to “conflicting pressures at all stages of their development and distribution,” it is extremely difficult to get a new vaccine approved by the FDA. This applies especially to the flu vaccine, whose construction is so much more complex than a formula because of the annually mutating virus it treats.

Even if the flu vaccine passes all of the stringent FDA regulations, the drug companies are faced with an extremely low profit margin, only 2 to 3% according to an article published in The Atlantic. This is because public agencies in charge of distribution buy at a capped price, which is predetermined and not subject to greediness or other monkey business. In fact, according to the Johns Hopkins magazine, the federal government’s large scale purchases of the flu vaccine at these capped prices are a main disincentive for producing vaccines that “historically have been high-volume, low-profit items anyway.”

Between the huge start up investment, and all of the risks of failure along the way, it is evident that drug companies are not producing vaccines as a sure fire way to make a profit.

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These risks, however, are incredibly discouraging for drug companies, and have had a negative effect on the supply of vaccinations in the U.S. According to an article published in the U.S. National Library of Medicine, there were 26 manufacturers of the flu vaccine in 1967, a number that dropped to 17 by 1980, then to 12 in 2015, only four of which are large-scale producers, like GlaxoSmithKline, one of the largest U.S. vaccine manufacturers.

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As drug manufacturers abandon their flu vaccine programs, a nationwide shortage could be taking place. For example, Erin Fox, manager of the drug information services for the American Society of Health System Pharmacists, told the Washington Post in 2011 that the shortage of vaccines was a worsening crisis that unnecessarily “puts patients at risk.”

Now that we’ve ascertained that pharmaceutical companies are not gouging U.S. citizens, we should ask: Can this problem solved?

Phil Russel, an MD and senior adviser at the Office of Public Health Preparedness, tackles this debate by defining the problem. He states that the U.S. market for vaccines is artificially skewed by corporations like the WHO, who both produce and buy vaccines in bulk, essentially cornering the market and creating very little incentive for other drug companies. This, combined with the amount of people who simply refuse to get vaccinated, is why vaccines are so unprofitable.

“We have to come back to some basic understanding of how valuable vaccines are to us, and how we translate that knowledge of value into a market,” Russell states, confronting anyone who protests the importance of vaccines in modern life.

 I think Phil Russell said it well, "We know how valuable fighter aircraft are to our defense and we pay the cost for them. Nobody bitched about the price for the smallpox vaccine. Whatever we needed, we paid." 

According to him, if the federal government gave more subsidies for the flu vaccine, drug companies could afford to spend more time matching them to each annual strain, and if people stopped doubting drug companies motives, perhaps the flu wouldn't be spread so commonly every year. 

What do you think?