Pharmacoeconomics for Dummies: 'Let's charge $60 for a $6 vaccine jab'

The latest NPC Podcast drops this morning. The organizers of the National Pharmaceutical Congress are proud to release our new weekly podcast series, hosted by Peter Brenders. Peter's guest this week will be Lee Ferreira of Ferring Pharmaceuticals. Listen here now. The NPC Podcast is proudly presented in cooperation with Impres Pharma 

⇒ Issue #85 (In numerology, the number 85 is a number of realism, encouraging the acceptance of a situation as it is and being prepared to deal with it accordingly.)
⇒ Confirmed Covid cases in Canada as of 07/29: 116,871*
⇒ Confirmed Covid fatalities in Canada as of 07/29: 8,957*
⇒ Worldwide Covid cases as of 07/29: 16,760,515*
⇒ Worldwide Covid fatalities as of 07/29: 660,978*

July 29, 2020—Hello Canada, and CurveFlatteners in the United States. Koko-bonking the keyboard this morning, in memory of the late Ed Shack, is Mitch “Foster” Shannon, with today’s play-by-play report coming live from the Chronicle gondola, suspended over the iconic intersection of Supply Street and Demand Terrace.

If you accept that Covid-19 is an existential threat to your family (and at this point, how could you not?), there are questions that follow. How much is it worth to you to eliminate the risk of contracting the pandemic? What sum would you pay right now to be able to return to something approaching life as it was before mid-March 2020?

Sixty bucks in Yankee greenbacks sound fair to you? That’s what stateside vaccine developer Moderna of Cambridge, Mass. is proposing to charge per patient for a course of their candidate Tx mRNA-1273, co-developed with the U.S. National Institutes of Health. But, hold on. Before you hand over your Amex card, join us on our boot-camp course in “Pharmacoeconomics 101, the Pandemic Edition.”

Pfizer and its German development partner BioNTech last week inked a pact with the U.S. federal government to provide their vaccine candidate -- assuming it will be proven efficacious -- for the low, low price of US$39 per course. That represents significant cost advantages until you consider that AstraZeneca recently signed a deal with four European governments to offer its comparable vaccine for just US$6 to $8 a course, which is less than a Happy Meal.

Of course, anyone with experience in the discipline will tell you there’s more to the abstruse science of Pharmacoeconomics than simply identifying the lowest cost supplier. Or is there? In the madcap race to create and bring to market an effective Covid-19 vaccine, laughingly dubbed “Operation Warp Speed” by the U.S. president, there is little precedent to follow, and Moderna appears to have the pole-position following its initiation of a 30,000-patient Phase III trial this week.

The World Health Organization has proposed that therapy developers might better serve humankind by meeting the moment to pool their intellectual properties and offer their discovery to a grateful planet at cost.

Um, don’t think so, says the defiant Moderna boss Stephen Hoge. Said he: “We will not sell it at cost.” Atta boy, Hoge. You need to stick with your boardroom principles. As they say in the used car business, “If you’re looking for a bargain, why don’t you go buy yourself a nice living-room rug over at K-mart?”

COVID CHRONICLE 07/29/2020

• Why is the Covid-19 mortality rate higher at the end of the week, or on the weekend? Epidemiologists puzzling over the seemingly inexplicable ebb and flow of Covid-19 morbidity and mortality data think they’ve finally hit on the cause of the fluctuations. It may not be the actual numbers, but it could be the reporting process. According to Aviv Bergman, Ph.D. of the Albert Einstein College of Medicine in New York City, “The practice of acquiring data is as important at times as the data itself." A study published this week in mSystems reports that so-called oscillations come from variations in testing practices and data reporting, rather than how people are infected or treated. The findings suggest that epidemiological models of infectious disease should take into account problems with diagnosis and reporting.
• How’s it going, eh? Actually, that was a serious research inquiry asked by psychologists from Germany’s Leipzig University and Saint Louis University in the U.S. of 979 people from across Germany. The study determined that in the early stage of the pandemic, up to May of this year, average life satisfaction and the experience of positive feelings decreased significantly, on average around 0.2 points each on a seven-point scale. Study results were published in the journal American Psychologist.
• Clinical trials of dornase-alfa (Pulmozyme, Genentech) began last week in ICU patients with severe Covid-19 pneumonia and respiratory failure requiring mechanical ventilation at Boston Children's Hospital and Brigham and Women's Hospital. The Tx is approved for patients with cystic fibrosis, to break up mucus secretions and prevent lung infections. Says principal investigator Dr. Benjamin Raby: "We hope this drug, which is known to be safe, will help reduce the inflammation that contributes to worsening respiratory distress in Covid-19."
• U.S. President Donald John Trump’s purported cure for Covid-19, hydroxychloroquine, though discredited by investigators, continues to be defended by a certain faction of the medical community, known to their colleagues as “imbeciles.” One such believer is Dr. Stella Immanuel, a Texas pediatrician who claims to have successfully treated “hundreds” of Covid patients with the quack nostrum. The website Daily Beast this week published some further theories of Dr. Immanuel, including the intriguing hypothesis that gynecological disorders are caused, as the article explains, by sex with demons that may occur in dreams. The Nobel Prize Committee is bound to sit up and take notice, especially now Dr. Immanuel’s landmark findings have been retweeted by... who else but President Trump?

STORIES CHRONICLE IS WORKING ON TODAY

Our John Evans is speaking with medical sources to develop a story about the efficacy and safety of abrocitinib in patients with moderate-to-severe atopic dermatitis.


RIGHT NOW I'M LISTENING TO...

After suffering through a few moments of observing U.S. Attorney-General William Barr on the afternoon newscasts yesterday, I'm currently applying some circa-2000 Warren Zevon music as an antidote. Some say his tune "Fistful of Rain" may be the singer-songwriter's very best work; regardless, the lyrics seem especially timely at this moment. "You can dream the American Dream,/But you sleep with the lights on,/And wake up with a scream."

HEY, WE MADE IT TO HUMP DAY

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That's it. Stay in touch, stay safe and enjoy your day. John Evans will be with you tomorrow with fresh Covid-19 news.