Economics of vaccines
Production is concentrated in the hands of a small number of powerful companies which acquire key legal monopolies and make very large profits.
Many of the diseases most demanding a vaccine, including HIV, malaria and tuberculosis, exist principally in poor countries.
[2] In almost all cases, pharmaceuticals including vaccines are developed with public funding, but profits and control of price and availability are legally accorded to private companies.
[7][5][13] A March 2020 New York Times article described the political effects of this market structure: "government and international health organizations know that any vaccine developed in a lab will ultimately be manufactured by large pharmaceutical firms.
[8] The first decade of the 2000s saw a large number of mergers and acquisitions, and as of 2010[update], 80% of the global vaccine market was in the hands of five multinationals: GlaxoSmithKline, Sanofi Pasteur, Pfizer, Merck, and Novartis.
Facilities that produce less than 100 million doses per year face diseconomies of scale, increasing the costs of vaccines.
[20][21] Ghana built a US$122 million vaccine manufacturing facility using funding from the International Finance Corporation of the World Bank Group, working with a consortium of three Ghanaian pharmaceutical companies.
[24] Vaccines developed for rich countries may also have short expiry dates, and requirements that they be refrigerated until they are injected and given in multiple shots, all of which may be very difficult in remote areas.
[8] In almost all cases, pharmaceuticals including vaccines are developed with public funding, but profits and control of price and availability are legally accorded to private companies.
[25] The profits of large pharmaceutical companies are mostly used on dividends and share buybacks, which inflate executive pay,[26][27] and on lobbying and advertising.
[28][27][29] Innovation is generally bought along with the small companies that developed it, rather than produced in-house;[26][27][29] low percentage R&D spending is sometimes touted as an attraction to investors.
Pharmaceutical companies have representation on the boards of public-private global health funding bodies including GAVI[33] and CEPI.
Baker claims that the US population would have better health care at lower cost if the results of that research were all placed in the public domain.
[4] Moreover, the cost of those diagnostic, preventive and treatment procedures would be lower the world over if the results of publicly-funded research were in the public domain.
