opinion: covid vaccine shortage and drug prices

faster than anyone could have anticipated, the initial phases of covid-19 vaccination have begun. yet, as doses are put into arms, many in canada have been rightly frustrated with announcements in  delivery delays .

there is no shortage of  finger pointing  by pundits and politicians alike, including attempts to blame shortages on canadian efforts to address high drug prices and enact a national pharmacare program. in reality, these efforts for fair drug prices have nothing to do with the current vaccine shortage. these reforms have everything to do with improving access to medicines for all.

canada has some of the highest drug prices and highest rates of  drug spending  in the world. a major contributor is the way medications under patent are priced, a responsibility of a federal regulatory agency called the patented medicine price review board (pmprb).

in 2017, the pmprb released a policy document entitled  protecting canadians from excessive drug prices . jane philpott, then minister of health,  said , “canadians are paying too much for prescription drugs” and that “measures (proposed for the pmprb) will go a long way toward helping canadians afford the medicines they need to live healthy, productive lives.”

she was right.  experts agreed  that the pricing changes would do just that. over a 10-year period,  savings to canadians are projected to be $8.8 billion .

more than three years after that announcement, implementation continues to be delayed, with  another six-month delay  announced last month. each step of the way, lobbyists for big pharma have  fought tooth and nail  to stall and weaken reforms.

industry lobby groups like  life sciences ontario  and  innovative medicines canada  repeat threats that drug companies will stop launching new drugs in canada and that amended regulations will hamper “the country’s ability to attract investment to our life-sciences sector.”

industry has been  making these claims for almost 50 years . the benefit of time has taught us that threats like this are only rhetoric, not reality.

the united kingdom, sweden and france are among the countries that  do a better job  of reining in drug prices while also achieving higher rates of research and development (r&d) than canada. this is despite lobbyists continuing to cite the necessity of high prices to support high investment. in fact, even with lower drug prices, these european countries will have a  much shorter interruption  in pfizer-biontech vaccine deliveries than canada.

the canadian contrast is telling.  in 2016 , sales of brand name drugs hit a record $20 billion while manufacturers of those drugs invested only 4.4 per cent of sales into r&d. despite the soaring revenues, the  pmprb reported  that this low percentage has been falling since the mid-1990s, failing to meet a prior commitment to achieve 10 per cent r&d in exchange for changing canada’s patent laws in favour of brand-name drug companies.

research  has  consistently  shown that drug prices are not linked to the levels of industry r&d in a country, despite pharma’s claims. instead, the links are the locations of head offices of these multinational companies, local infrastructure to conduct clinical trials and the presence of a strong scientific community doing basic research that provides the foundation for new drugs.

in the mid-1990s, british columbia  introduced  “reference pricing” to support evidence-based drug coverage and lower drug spending. like now, and for the past 50 years, industry threatened to halt r&d investment in b.c. however, the b.c. government moved forward with these reforms  and a 2008 study  found that the changes had no negative effects on pharmaceutical r&d. in fact, from 2001 to 2003, r&d investment in b.c. performed better than expected.

for example, the  critical drugs coalition  is calling on canada to create a publicly owned generic drug manufacturer for critical medications; maintain a properly stocked strategic stockpile of these medications; and allow greater transparency on critical medicine supplies to ensure that supply issues are addressed before there is risk to patients.

a growing number of countries led by india and south africa are pushing for “ compulsory licensing ,” a move that would temporarily suspend patent rights and increase manufacturing capacity and access to covid-19 medications, vaccines and diagnostic techniques. while far from the potential of compulsory licensing,  sonafi  and  novartis  recently announced agreements with pfizer to boost production of the biontech vaccine in an incremental move in this direction.

doctors without borders canada  is demanding the federal government attach conditions to r&d that ensure medicines and vaccines developed with public funds be affordable, available and accessible for all – not priced out of reach for patients and health systems.