A health worker opens a freezer during a Covid-19 vaccine test in Delhi on 2 January.
Photographer: T. Narayan / Bloomberg
Photographer: T. Narayan / Bloomberg
As major countries like the United States and China compete to vaccinate their populations with rapidly approved traits, tens of millions of prepared doses for India remain in storage despite being authorized for use.
Although distribution in other nations began shortly after approval with previously signed price agreements, New Delhi and Serum Institute of India Ltd., the largest vaccine manufacturer in the world by volume and The local partner of AstraZeneca Plc: has promised in months to bargain behind closed doors and has not yet signed a formal supply agreement. This has left at least 70 million doses of vaccine in limbo despite the urgent need in a country facing the second largest outbreak in the world.
Photographer: Dhiraj Singh / Bloomberg
On Sunday, Serum billionaire Adar Poonawalla said Indian officials have agreed to “orally” buy 100 million doses at a “special price” of 200 rupees ($ 2.74) the shot, below the Price $ 4 to $ 5 awarded to the UK government. The company then wants to sell vaccines privately to individuals and businesses at a marked cost of 1,000 rupees within two to three months.
According to Abhishek Sharma, an analyst at Abhishek Sharma, the Indian government could be looking to pressure Serum to lower its prices, according to its controversial decision to give the green light to a rival vaccine developed by a local company that still recruits volunteers for testing. the final phase Jefferies.
The confrontation has cost precious time in a country where infections have surpassed 10 million and reflects the tension between the public interest and the private use of pharmaceutical companies that want to recoup their pandemic investments quickly.
While richer developed economies have largely avoided price disputes in their launches so far, it is likely that the question of how much inoculations should cost in the midst of a pandemic that kills more than 10,000 people every day worldwide in as distribution spreads to developing countries.
For Prime Minister Narendra Modi, every penny spent on the price of a vaccine in a nation where there are more than 1.3 billion people will have serious economic consequences for his administration.
“When it is bought in bulk, there is obviously the advantage of being able to negotiate the price,” said Randeep Guleria, a member of Modi’s working group for Covid-19 management and director of the Institute of Medical Sciences of India. interview Monday. He added that negotiations are underway under the procurement policy and “obviously, they could also decide what the market price should be next.”
Guleria said the purchase agreement would be signed “any day now.” India is ready to roll out Covid-19 vaccines within ten days of its approval by the drug regulator, Health Secretary Rajesh Bhushan told reporters at a briefing on Tuesday. He did not say whether a supply or price agreement had been signed.
It took five or six days for the first blows to be deployed by the UK after granting emergency gestures to the Pfizer Vaccines Inc. and Astra-Oxford.
“Bad deal”
In October, people with knowledge of the matter told Bloomberg that New Delhi has been sidelined Rs 500 billion for vaccination efforts, estimating a total cost of about $ 6-7 per person. An Indian health ministry spokesman could not be reached for comment.
“The government does not allocate money to the private sector so easily,” said Ramana Laxminarayan, founder of the Center for Disease Dynamics, Economics & Policy, from the Indian capital. “They’re just good at playing the game because they have budgetary pressures: the bureaucrats, if they come back with a bad deal, the minister will send them right away and tell them, ‘Get a better price.'”
The blue version of vaccination in India indicates that 300 million people will be inoculated in the first phase of deployment, starting with health workers, followed by police and soldiers, and then those with comorbidities and people over 50 years. it would take three to four months to complete.
Workers are transporting a temperature-cooled container to Indira Gandhi International Airport in New Delhi on December 22, 2020.
Photographer: Anindito Mukherjee / Bloomberg
Local officials across the country have been asked to compile priority vaccination lists, but preparatory work appears uneven, according to interviews with local doctors and representatives. Some localities also appear to be preparing to administer two different vaccines at once.
Although AstraZeneca’s shot has been tested in global trials and has received an emergency license from British and Indian regulators in recent days, Hyderabad-based vaccine developer Bharat Biotech International Ltd. it has not yet begun analyzing phase 3 test data, but it has also received controversial limited approval for use by the South Asian country over the weekend.
“There will be several vaccines that will be used,” said Amit Thadani, a surgeon at Bombay’s Nirmaya Hospital. “They’re going to assign a particular type of vaccine to use only in one district, so if there’s a problem, it’s easy to identify which particular vaccine is causing it.”
Serum, which has an agreement with AstraZeneca to produce at least a billion doses, has already reduced the initial production target by 100 million in December due to slower approvals than expected.
Poonawalla began publicly airing debates over possible vaccine prices in September, which some health experts saw as part of a pressure effort.
In Sunday’s interview, Poonawalla was optimistic that a written agreement would soon be reached in a couple of days. “We’ve already packaged it, just ship it to all states and deliver it,” he said, referring to the 70 million doses the company is ready to distribute.
“Quick Approval”
Meanwhile, India’s decision to grant Bovat Biotech’s Covaxin restricted approval despite the lack of final test efficacy data, which has put observers in jeopardy. In August, the company’s president, Krishna Ella, told a conference that his vaccine would be cheaper than bottled water, which costs less than half what Serum offers for the vaccine. ‘AstraZeneca.
“The hasty approval of Covaxin, even as a secondary candidate, is driven primarily by the commercial considerations of the Government of India,” Sharma, a Mumbai health Jefferies analyst, said in a report on Sunday. If Covaxin “is able to demonstrate efficacy in the coming months, subsequent vaccines will have to compete in both price and efficacy.”
The rapid approval of Bharat Biotech may also be due to India not wanting to be forced to a single vaccine manufacturer.
In an echo of a long-standing debate over the role of private pharmaceutical companies, there is growing concern that Serum’s position as the sole national supplier of a potentially life-saving vaccine is too powerful.
Outside India, AstraZeneca only supplies governments and has not yet signed any private agreements with companies or individuals. However, Serum wants to access the private market with a higher margin in a few months, where it plans to increase the price of the figure five times, according to the price plans shared by Poonawalla.
First engine
The proposed price of 1,000 rupees per dose is “absolutely the price of exploiting and taking advantage of its position as the first engine,” said Malini Aisola, co-convener of the All India Drug Action Network, an agency of New Delhi-based health surveillance. “Personally, I don’t think they should approve private use at this time.”
But for the best of India’s stratified society, it is not an option to expect the Byzantine public health system to distribute doses.
A large private bank is yet to receive guidelines on government reference dates and prices that will allow it to consider purchasing vaccines directly from manufacturers, according to lender officials, who asked that they not be identified as deliberations are private.
For now, Serum is still awaiting his first government order. Poonawalla said India first needs to secure enough vaccines for the most needy. “If we sold it the way we wanted, it makes sense that some of the most vulnerable people would get lost,” he said.
New Delhi also knows that the vaccine manufacturer will not be able to easily shift these massive volumes to any other place.
“India buys a lot of vaccines at 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 will not be so easy for them: the government has ways to rely on it.”
– With the assistance of Ragini Saxena and Suvashree Ghosh