When pharmaceutical giant Pfizer offered the humanitarian organization Doctors Without Borders a donation of one million doses of a pneumonia vaccine, the group responded with a shocking and counterintuitive answer: they said no.
The reason why illuminates the fundamental problem that drives the running battle between pharma companies and the patients they purport to be creating drugs for.
Drugs are becoming unaffordable for certain parts of the world, so companies respond to decreased purchases by raising prices in order to make up the shortfall. So a story that's already played out with the massive price hike on the EpiPen plays out again: life-saving drugs are made so expensive that those who need them can't get them - and the companies who raised the price wring their hands and complain it's all they can do to stay solvent.
In the case of the pneumonia vaccine, the stakes couldn't be higher. Pneumonia is the leading killer of children worldwide, and Pfizer’s vaccine, marketed internationally as Prevnar 13, has cut down the mortality rate from it in the U.S. by nearly 90 percent. But it’s incredibly expensive: $136 for one dose in the U.S., and the vaccine requires four doses to be completely effective. Developing nations around the world are in desperate need of the vaccine, but with the costs so high, their people can only watch as nearly one million children die every year.
To be sure, this was not a decision made lightly.
Doctors Without Borders Executive Director Jason Cone wrote a post for Medium detailing the thought process behind the refusal, and laid out in stark terms the reasons why simply donating vaccines is not a solution. Free donations often have onerous strings attached, Cone explains, and can be used as an excuse for inflated prices. They’re giving so much away that the only way they can make money is to keep it expensive. Beyond that, they often serve as high-profile, feel-good tax breaks.
The organization desperately needs the vaccines – but a small free donation pales to the impact that Pfizer reducing the price of the vaccine would have. Pfizer and GlaxoSmithKline (GSK) are the only makers of the pneumonia vaccine, and therefore have the luxury of keeping prices at whatever level they wish. As Cone announced in his Medium post, after years of negotiation, GSK dropped the price on their vaccine to about $3 per dose for humanitarian organizations. This is a cost well within the capabilities of groups like Doctors Without Borders – and has none of the strings that a “donation” carries.
But Pfizer refuses to follow GSK, nor will they give a reason for such a refusal. In a statement to Fortune Magazine, the pharma giant said only "Pfizer strongly disagrees with MSF’s stated policy and believes product donations play a crucial role in addressing humanitarian crises around the world. We reiterate our offer of 1 million free doses and continued supply to meet these urgent, emergency needs.”
Until Pfizer agrees to at least some kind of price drop, the cost of a free vaccine will simply be too high for Doctors Without Borders. Children in the developing world don’t need tax-break charity – they need sustainable prices for drugs.