By Jay Hancock, Kaiser Health News
Johnson & Johnson researchers working on a vaccine against the coronavirus are “just like the heroes in the hospitals” fighting to save patients, J&J CEO Alex Gorsky said on the Today show a few weeks ago.
It’s a message he likes to deliver. In recent weeks, Gorsky has talked about J&J’s efforts on NBC’s Today and twice on CNBC and Fox. Nobody asked him about high drug prices, J&J’s role in the opioid crisis, or lawsuits alleging its baby powder caused cancer.
J&J and the rest of the pharmaceutical industry have seized on the coronavirus crisis as a way to polish an image tarnished by unaffordable medicine, patent lawsuits, and an addiction epidemic.
The potential payoff is clear: If drug companies can produce a successful vaccine or therapy against the biggest infectious threat in a century, “maybe you can start to undo some of that reputational damage,” said Michael Kinch, head of the Centers for Research Innovation in Biotechnology at Washington University in St. Louis. “I have to wonder if that’s some of the motivation.”
A top pharmaceutical executive recently told him: “When I entered this industry, we were the most respected industry in the world. Now we’re below tobacco.”
But it is uncertain which, if any, of the firms trying to claim center stage now—J&J for vaccines, Gilead for its antiviral, or Abbott for its testing machines—deserve the leading role or will have it when new products arrive on the market and are priced.
Their star turn comes after what critics say have been decades of underinvestment in vaccines and medicines for the most common viral diseases in favor of more lucrative drugs that are less important to public health. The industry is talking about serving the public good while setting itself up for profits, downplaying the government's role as a research partner and exaggerating prospects for victory, they say.
J&J’s vaccine candidate “has a high degree of probability of being successful against the COVID-19 virus,” Gorsky said on NBC’s Today.
But Gorsky “doesn’t know that yet,” given the difficulties of vaccine development and the many chances for failure, said Dr. Paul Offit, co-inventor of a rotavirus vaccine and a professor at the University of Pennsylvania’s Perelman School of Medicine. “We should be humble about this virus, about what the likelihood is for protection.”
Three years ago, President Donald Trump said drug companies were “getting away with murder” by charging so much for medicine. In early March, he instead called pharma CEOs “geniuses” at a White House meeting and said “we’re very proud” of their work.
J&J is producing an eight-episode streaming series called “The Road to a Vaccine,” in which CNN personality Lisa Ling interviews company officials, patients and scientists. A Financial Times profile on Gorsky was so flattering the company put out a press release drawing attention to it.
“When science wins, we all win,” says a new ad from Pfizer, which recently began human trials on a coronavirus vaccine. Executives at Gilead, maker of the antiviral remdesivir, “recognize the human suffering, the human need here,” company CEO Daniel O’Day said on CBS’ Face the Nation on May 3.
“Science is how we get back to normal,” says a new campaign from the Pharmaceutical Research and Manufacturers of America, the industry’s biggest lobbying group.
Trump administration officials, and even Dr. Anthony Fauci, the top infectious disease expert on the president’s coronavirus task force, say a vaccine could be available within 12 to 18 months—far faster than any other such treatment has been developed.
Such a schedule would be inconceivable without previous research by pharma companies, industry officials say.
“There are 70 vaccines in development for COVID-19 and several of them are already in human testing,” said PhRMA spokesperson Priscilla VanderVeer. “A lot of this is happening because the industry believes in vaccines, and many companies have made investments in vaccines."
J&J officials, whose vaccine research has been aided by tens of millions of dollars in federal support over the years, say their recent experience developing a vaccine for the Ebola virus and potential vaccines for HIV, Zika, and other bugs gives them the ability to move quickly. The company’s newly expanded plant in the Netherlands is able to make hundreds of millions of doses a year, they say.
But drug companies have been drifting away from vaccine research for decades, say independent authorities. They make far more money treating chronic ailments with regular pills or injections for years than on preventing disease.
“Because vaccines are largely unattractive financially, we’ve dismantled a lot of capabilities to develop them,” Kinch said. “If you look at the net number of vaccine-preventable infections, it actually hasn’t changed in about 20 years.”
Recent vaccine successes include treatments against human papillomavirus and Ebola and a new vaccine for shingles. But today only four companies make vaccines for the U.S. market, said Offit. That’s down from 27 in the 1950s and 18 in 1980, he said.
“Vaccines are something you give once or a few times in a lifetime,” he said. “They are never going to be blockbusters.”
Drug companies invested in potential vaccines against Ebola, SARS (severe acute respiratory syndrome), Zika, and other infections in recent years only to lose money when concerns over the diseases faded.
Vaccine research has largely been left to small biotech companies and academic scientists funded by the government and nonprofits such as the Bill & Melinda Gates Foundation. The World Health Organization lists 83 potential candidates for coronavirus vaccines, almost all in early development.
Such a number “shows there is substantial capacity on the development side,” if not on the manufacturing side, said Dr. Walter Orenstein, a professor at Emory University and former director of the U.S. immunization program for the Centers for Disease Control and Prevention.
But small firms can’t afford the major expense of bringing the drugs to market—testing them on humans, and then manufacturing and distribution. Only a huge company can do that.
On Feb. 11, Fauci was lamenting that no major U.S. drugmaker had committed to making a coronavirus vaccine. He called it “very difficult and frustrating.”
Since then, as the disease and potential market have exploded, J&J’s Janssen division and a joint venture between giants Sanofi and GlaxoSmithKline have backed potential vaccines, as has Pfizer.
On March 30, J&J and the Trump administration announced a vaccine partnership that includes a massive, $456 million investment by U.S. taxpayers and similar spending by the company. On April 16, Moderna, a small biotech company, said it will receive up to $483 million in federal funds to speed the development of its vaccine candidate.
With so much government money at stake, corporate recipients should make detailed disclosures of how it is spent, said David Mitchell, the founder of Patients for Affordable Drugs, a consumer group.
Money will be an issue again, too. In February, Alex Azar, Health and Human Services secretary, said he was unable to promise that a coronavirus vaccine would be affordable for everybody. Gilead, whose stock has jumped 20 percent this year, will be guided by “principles of affordability” in marketing remdesivir, O’Day said recently. But it hasn’t set a price.
J&J has said it will offer its vaccine “on a not-for-profit basis for emergency pandemic use.” It is the only developer so far promising to limit profits on coronavirus vaccines. Mitchell said the company should spell out what that means and pledge to forgo all profits for the treatment, not just during the emergency.
“When taxpayers are involved, we should have a say in what the price is and what the profit is,” he said. “There is plenty in Johnson & Johnson’s history to show why you should be cautious in dealing with them.”
A J&J spokesman did not respond when asked to comment on the Patients for Affordable Drugs proposal.
Kaiser Health News (KHN) is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.