Intelligence Briefing on the challenges of the global response to COVID-19.
¨3. Distortion and rent-seeking in COVID-19 intervention research
... COVID-19 has already provided significant opportunities for the realization of large economic rents in the vaccines and pharmaceuticals sector. The non-governmental Coalition for Epidemic Preparedness (CEPI), which works alongside GAVI and WHO, granted US$388 million to Novavax, driving a massive jump in its stock price in anticipation of monopoly profits. Executives at Moderna raised eyebrows by arranging for legal sales of stock, timed to take place immediately after encouraging announcements on its candidate COVID-19 vaccine. Large sums of public funding are also available for candidate treatments for COVID-19, spurring feverish activity by large and small pharmaceutical firms alike, often backed by hedge funds and using technologies licensed from university-based, publicly funded research (Rowland, Reference Rowland2020). One important strand of the surprising controversy over the use of the antimalarial agent hydroxychloroquine in COVID-19 (see Box 1) has been the tension between repurposing old and off-patent drugs (like hydroxychloroquine and the steroid dexamethasone), which offer only limited profit opportunities, and novel agents (such as remdesivir), which offer the prospect of patents and monopoly rents. The willingness of the US government to advance purchase almost all of the manufacturing pipeline of remdesivir for July, August and September will certainly cement these profits for the drug's makers. It is perhaps unsurprising that there has been even less enthusiasm for conducting badly needed research into key social interventions (such as the use of facemasks by the general public or specific aspects of social distancing), which offer even less prospect of future profitability.
Box 1. The hydroxychloroquine roller coaster.
... In a politicization of pharmaceutical science not seen since the peak of South African AIDS denialism in the early 2000s, acceptance of evidence for or against HCQ split down partisan lines in the USA. A major global study in the prestigious medical journal The Lancet reported that HCQ showed no benefits in COVID-19 and provided evidence of elevated cardiovascular adverse events and decreased survival in patients receiving the drug. The HCQ arms of several major international trials were immediately suspended, and several nations advised against using the drug for COVID-19. Yet little more than week later, the study's authors retracted it in full – along with a parallel study on cardiovascular risk in COVID-19 patients, published in the New England Journal of Medicine – after it emerged that the commercial dataset that they had used was at best unvalidated, if not actually fraudulent... [Hydroxychloroquine] provides an extraordinary illustration that scientific error and misconduct can occur even in the midst of the response to a global public health emergency."
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