Doctors without Borders refusing free Pfizer vaccines

[StNeotser]

Doctors Without Borders Refuses Vaccines from Pfizer - The Atlantic

Quote

This week the medical-aid organization Doctors Without Borders refused a donation of one million vaccine doses from the pharmaceutical corporation Pfizer. It offered inoculations against a commonly fatal pneumonia deliverable immediately, to people in need anywhere and the doctors said no.

The decision is the result of a fundamental impasse in modern healthcare. The heart of the refusal which could well imperil children who would have received those vaccines is a principled stand against the extremely high cost of many vaccines.

I'm not sure where I stand on this one. I feel they should have accepted the vaccines, yet I understand why MSF are taking this position. What are your thoughts?

[SororAKS, ADN, RN]

That's not true. We trade labor for wages. That is completely different than "profit", which is surplus value extracted from labor. Corporate profit is, in fact, a dollar-for-dollar competitor with labor, future R&D, and production costs on a company's balance sheet.

It is entirely possible to deliver healthcare under a non-profit model, as Kaiser Permanente, many community hospitals, university medical centers, the NHS, VA, and many other publicly-financed health systems around the world demonstrate. That these organizations have historically been major developers of new therapies and interventions should put to rest the myth that innovation does not happen without a profit motive. How many new surgical techniques have been developed at Johns Hopkins, without any profit motive?

Whether that model can work in pharmaceutical development is an open question. A fair number of universities have opened drug-development research centers in the past decade or so, in some cases because they recognize that new treatments for certain health conditions will never be profitable without extraordinary costs to individual consumers, or that potential margins are too low to attract investors in the private sector. Time will tell what kind of drugs these groups can produce.

Given that healthcare is driven primarily by highly inelastic consumer demand for not getting sicker/not dying, I think it is a perfectly valid question whether profits belong in the picture at all.

The For Profit motive creates an automatic conflict of interest in healthcare.

[Jolie, BSN]

The For Profit motive creates an automatic conflict of interest in healthcare.

How so?

[SororAKS, ADN, RN]

How so?

If one believes that healthcare is a human right, then requiring those that need it (all of us at some point)to purchase it puts those without the means to do that at a disadvantage.

If hospitals and healthcare facilities are for profit corporations, they may be more likely to shave operating expenses (nurse staffing is one) in order to fatten up the bottom line and keep the shareholders of the corporate stock happy. This can create higher morbidity and mortality rates in patients of said facility.

When money, and making more of it, becomes more important than things like proper and safe staffing or accessability to healthcare, you have an inherent conflict of interest. Not automatic necessarily, but inherent.

The pharmaceutical industry is notorious for charging outrageous prices for their products. Google the recent discussions about Epi Pens as well as the comparisons of what drugs cost in the us vs canada and europe.

For profit is not automatically a conflict of interest, but with healthcare as its product, the incentive to place profits over people is unfair to those that need that care or product because numbers and making lots of money off the product or services can become more important than healing or assisting them to better health.

[Jolie, BSN]

We apparently agree that "For profit is not automatically a conflict of interest."

There is nothing inherently bad about earning a profit, nor is there anything inherently good about non-profit status.

It is entirely possible for a well-run for-profit entity to better serve society than a non-profit counterpart, and vice versa. We could give examples of both.

This thread is not about insurance, so I won't go on that tangent, but I believe that the for-profit or not-for-profit status of a healthcare entity often has less to do with the affordability of a product or service than the method of payment, location, competition, etc. There are multiple factors that impact the cost and availability of needed healthcare.

[Spidey's mom, ADN, BSN, RN]

I think they could have found a different way to make their concerns known. In the meantime, "the leading cause of death in children is pneumonia" and they turned down one million vaccines.

That's just selfish in my opinion.

[Extra Pickles]

I'm not sure where I stand on this one. I feel they should have accepted the vaccines, yet I understand why MSF are taking this position. What are your thoughts?

My thought is that making a political stand on an issue shouldn't be made while standing on the bodies of one million children. The children that die because they didn't receive this vaccination sure aren't better off because of the stand of the physicians. To me this was a very wrong decision. Denying healthcare to children they are specifically there to take care of is about as wrong as it can get. Take care of the children. Find another way to make a political impression!

[herring_RN, ASN, BSN]

There is No Such Thing as Free” Vaccines: Why We Rejected Pfizer's Donation Offer of Pneumonia Vaccines

... Pneumonia claims the lives of nearly one million kids each year, making it the world's deadliest disease among children. Although there's a vaccine to prevent this disease, it's too expensive for many developing countries and humanitarian organizations, such as ours, to afford. As the only producers of the pneumonia vaccine, Pfizer and GlaxoSmithKline (GSK) are able to keep the price of the vaccine artificially high; since 2009, the two companies have earned $36 billion on this vaccine alone. For years, we have been trying to negotiate with the companies to lower the price of the vaccine, but they offered us donations instead...

... Isn't free better?

No. Free is not always better. Donations often involve numerous conditions and strings attached, including restrictions on which patient populations and what geographic areas are allowed to receive the benefits.

This process can delay starting vaccination campaigns, which would be an untenable situation in emergency settings, or grossly limit who you're able to reach with the vaccine.

Donations can also undermine long-term efforts to increase access to affordable vaccines and medicines.

They remove incentives for new manufacturers to enter a market when it's absorbed through a donation arrangement. We need competition from new companies to bring down prices overall — something we don't have currently for the pneumonia vaccine.

Donations are often used as a way to make others "pay up."

By giving the pneumonia vaccine away for free, pharmaceutical corporations can use this as justification for why prices remain high for others, including other humanitarian organizations and developing countries that also can't afford the vaccine.

Countries, which continue to voice their frustration at being unable to afford new and costly vaccines such as PCV, need lower prices as well to protect children's health.

Critically, donation offers can disappear as quickly as they come. The donor has ultimate control over when and how they choose to give their products away, risking interruption of programs should the company decide it's no longer to their advantage.

For example, Uganda is now facing a nationwide shortage of Diflucan, an essential crytpococcal meningitis drug, in spite of Pfizer's commitment to donate the drugs to the government.

There are other similar examples of companies' donation programs leaving governments and health organizations in a lurch without the medical tools they need to treat patients.

To avoid these risks and to limit the use of in-kind medical products donations, the World Health Organization (WHO), and other leading global health organizations such as UNICEF and Gavi, the Vaccine Alliance, have clear recommendations against donation offers from pharmaceutical corporations...

There is No Such Thing as Free” Vaccines: Why We Rejected Pfizer's Donation Offer of Pneumonia Vaccines | MSF USA

[herring_RN, ASN, BSN]

MSF already negotiated lower prices with GlaxoSmithKline (GSK)

MSF Welcomes GSK's Decision to Lower Price of Pneumonia Vaccine for Some of the World's Most Vulnerable Children

The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) welcomes the decision by GlaxoSmithKline (GSK) to lower the price of its pneumococcal conjugate vaccine (PCV) for humanitarian organizations that serve refugee and crisis-affected children.

For seven years, MSF has been in discussions with GSK and Pfizer—the only two producers of the pneumonia vaccine—for access to a more affordable price.

GSK's price reduction is a significant step forward in protecting vulnerable children who are reached by humanitarian organizations like MSF.

MSF now hopes that Pfizer will match GSK's offer, and that both companies will additionally reduce the price of the vaccine for governments of developing countries that still can't afford to add the PCV vaccine to their standard childhood immunization package...

... Until now, neither MSF nor other humanitarian organizations have been able to purchase pneumonia vaccines at an affordable price. Earlier this year, MSF paid $68.10 for one dose ($204.30 for the three doses needed to vaccinate one child) of the Pfizer product to vaccinate refugee children in Greece—20 times more than the lowest price that GSK and Pfizer offer.

In April, MSF delivered the names of more than 416,000 people from 170 countries who signed a petition asking Pfizer and GSK to reduce the price of the pneumonia vaccine to $5 per child (for all three doses) for crisis-affected populations and for all developing countries...

... With its September 19 announcement, GSK has now pledged to offer humanitarian organizations a price of approximately $9.00 per child ($3.05 per dose)...

MSF Welcomes GSK's Decision to Lower Price of Pneumonia Vaccine for Some of the World's Most Vulnerable Children | MSF USA

[Kooky Korky, BSN, RN]

That's not true. We trade labor for wages. That is completely different than "profit", which is surplus value extracted from labor. Corporate profit is, in fact, a dollar-for-dollar competitor with labor, future R&D, and production costs on a company's balance sheet.

It is entirely possible to deliver healthcare under a non-profit model, as Kaiser Permanente, many community hospitals, university medical centers, the NHS, VA, and many other publicly-financed health systems around the world demonstrate. That these organizations have historically been major developers of new therapies and interventions should put to rest the myth that innovation does not happen without a profit motive. How many new surgical techniques have been developed at Johns Hopkins, without any profit motive?

Whether that model can work in pharmaceutical development is an open question. A fair number of universities have opened drug-development research centers in the past decade or so, in some cases because they recognize that new treatments for certain health conditions will never be profitable without extraordinary costs to individual consumers, or that potential margins are too low to attract investors in the private sector. Time will tell what kind of drugs these groups can produce.

Given that healthcare is driven primarily by highly inelastic consumer demand for not getting sicker/not dying, I think it is a perfectly valid question whether profits belong in the picture at all.

Non-profit does not mean not profitable.

[elkpark]

Non-profit does not mean not profitable.

Of course not, but it does mean that money is not getting siphoned off the top to put profits in shareholders' pockets. "Profits" realized by nonprofit organizations get put into improving facilities and services, and benefitting the community in various ways.

It also means that turning a profit is not the organization's top priority, as it is for for-profit businesses.