511–520 of 569 posts
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I wonder what happens if you get two doses, but not of the same vaccine?
Can you share your thinking around why someone would want to do that given that a combination won't be tested (at-least rigorously). Are you seeing benefits from a logistics point-of-view?
I'm thinking it's going to accidentally happen to some people, at least if there are facilities that offer more than one vaccine.
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I think it should always be insanely profitable to save the world! That is something we want to encourage!
We should have drug bounties for that, rather than trying to make up R&D costs with per-dose price gouging. This ensures equitable access, ...you know, that the whole world is actually saved.
In reality, these costs are microscopical compared to the cost of the Covid recession, and all the "stimulus packages" across the planet.
I assume most governments will pay the cost of vaccines, or even pay people to take the shots. The US says it will.
We (Britain) may have totally screwed up our general response to COVID. But at least we’re still pretty good at science. Thanks Oxford for saving the day.
Not to downplay Oxford or Britain's work, but I think it's safe to argue that the poor general response to COVID is also an indicator of your skill at science. And I say this as American, who's response was just as bad or worse. People are going to look back at this pandemic with amazement at the work the world scientists did to create a vaccine in record time, but with shame and embarrassment at the loss of life in…
This isn’t safe to argue at all. In fact, it’s completely wrong. We know that the poor UK response is almost exclusively due to politicking and government corruption. The scientific advisory panel of the government (SAGE) hasn’t always been right in their assessment but they very quickly produced rigorous working models and solid recommendations, most of which have mirrored (and continue to mirror) the international consensus. Furthermore, public research in the UK has, sometimes against the active opposition of the government, done stellar work to ramp up testing and genetic sequencing.
For instance, several institutes (incl. the Crick Institute in London and the University of Cambridge) had extensive testing capabilities set up in record time, but their offers to official channels were ignored for weeks, if not months (the Crick in particular simply ignored this and already provided testing internally and externally, at a time when basically no country had widespread testing yet).
Likewise, a collaboration of different institutes quickly set up genome sequencing pipelines for COVID-19 samples, and as far as I know the Sanger Institute is sequencing more COVID-19 samples than any other individual entity in the world: https://www.sanger.ac.uk/about/who-we-are/sanger-institute/t...
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Just because Pfizer's stock drops doesn't mean they can't fund their R&D. Pfizer has $10B in cash.[1] [1] https://finance.yahoo.com/quote/PFE/balance-sheet/
A 40-50% reduction in share price would have most probably eliminated the dividends completely, especially in a very adverse deflationary market, which most definitely would have seen the most of that $10 billion sum allocated to other things than R&D.
Pfizer's cash situation or ability to spend/pay a dividend has nothing to do with stock price. Pfizer does not have their cash balance invested in other stocks. Ability/willingness to pay a dividend has to do with excess cash.
To the extent there's any relation, it's a high stock price that discourages paying a dividend. If the dividend yield will be basically nothing, why bother spending down precious cash that could be reinvested (because obviously the market values future cash flows a lot more than current ones).
Deflation might encourage a little bit of holding of corporate cash rather than spending it on R&D, sure. But even then I think you're overstating the case.
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No. GP said idea to product costs 1B just for r&d. That and 1B amortized over failures (and including marketing) cannot be true at the same time unless there are no failed attempts and unless marketing cost is zero.
I've seen you mention marketing several times. What expenditures would you include as a marketing expense? I'm also not sure what you would define as a failure. Drug development often starts with several candidates for a target. Over the cause of development the list is trimmed, as candidates show lack of affinity for the target or have side-effects that make them unviable. Would you consider each of the excluded can…
I don't get to define that, companies do, but basically it includes everything that does not involve a lab, technician, doctor, nurse, statistician/programmer, etc. The US and the rest of the world are quite different here - if you've ever watched US broadcast in the evening, you'd see TONS of ads for prescription only medicine ("suffering from foo? Ask your doctor about bar"); that's marketing. Taking three hundred cardiologists on an all-expenses-paid 7-day cruise with one 30-minute "purely informative lecture about our new drug" and 7 days of fun? That's marketing too. Lobbying to congress? That's also marketing.
Outside of the US, the marketing budgets are smaller and less overt - but the cruise-style legal bribe-like events are prevalent everywhere.
> Would you consider each of the excluded candidates a failure?
Possibly. You've described one style, but it's not the only one. Many times, it's a weird result from some other research (how Viagra was discovered, how DCA tests were started).
But many things are essentially complete and utter failures - you have a line of research where no viable compound was found at all. BiondVax just failed a 15-year mission trying to develop a universal flu vaccine. Remdesivir is essentially failed even though it is FDA approved (It failed for Ebola; if you look at the data critically, it failed for SARS-COV-2 -- which the WHO's recent studies show even more clearly).
There is some benefit from this research - new techniques, often new devices - but the drug itself is a failure in the sense that it will not generate any income to the company.
Edit: just saw your earlier comment about marketing. It is those things (which you and I mentioned) and a lot more, but it is basically for the company to define in their books and a rule of the thumb would be “an expense a university department developing this to completion without expectation of profit would not have to spend”
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No, the Russian one that was released for public use was developed by one of the government institutes (which has a very shady history of falsifying data).
> has a very shady history of falsifying data Source?
I know it's CNN (what I could find with 5 mins of Googlefu) and they don't explicitly mention the falsified data part. But the Gamaleya Institute is well known in Russia for falsifying data both as a propaganda machine, as well as to obtain further funding from the federal government. I can't find another source I read earlier concerning a past instance of fraud perpetrated by the institute (it was in German).
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Curious, in your healthcare experience, what would you estimate is the percentage of people who do have good insurance, but don't get preventative care by choice? E.g. for myself, I have good insurance, but I don't have a "primary care doctor." I don't go to the doctor unless I'm injured or sick. And I don't mean a sniffle or cough, I mean sick as in I have felt awful for several days.
If you have insurance and are not going for a routine exam once a year, you're doing a disservice to yourself because you miss the opportunity to catch issues that can be easily fixed when caught early but catastrophic if not. In fact many corporate policies require people to have regular exams exactly for this reason.
The average American sees a doctor 3 times per year. In France it is 6-7 times per year. In Japan, it’s 13 times per year. This statistic is directly linked to the cost of care.
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The safety concerns cannot be resolved yet. Effective - yes. Safe? We won’t know for a while. Pandemrix, a flu vaccine, caused a notable uptick in narcolepsy in Sweden, Finland and likely the UK. This was not (and could not) be seen in smaller trial populations. It is not a given that any of the covid vaccines is safe enough. Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than t…
> Historically, two cases of rushed vaccines (cutter polio and Gullah barre) were worse than the disease - and these were for diseases worse than covid. This is just patently untrue. The Cutter Incidence gave patients Polio due to an improperly activated virus. While this is bad, it could not be worse than the disease itself - since it is the disease itself, no worse, no less. Regarding risk of Gullain-Barre syndrome…
Sure, having Guillain-Barre is scary, but it is something that you can make a full recovery from.
It is never an excuse NOT to get a vaccine, unless you actually know that you got Guillain-Barre Syndrome from a vaccine. That is a discussion between that particular patient and their neuromuscular neurologist. In that case, you do not get the flu vaccine any longer because it can cause you to experience Guillain-Barre Syndrome again.
But, this really is an isolated situation that can be categorized as very rare and the general public should always get their vaccines.
If you catch the flu, it can absolutely trigger Guillain-Barre Syndrome, and would be far more likely to trigger Guillain-Barre Syndrome than the flu vaccine itself. If you get the flu and had the flu vaccination, it typically makes the flu illness less worse, making you less likely to get something like Guillain-Barre Syndrome.
There are lots of infectious agents that can trigger Guillain-Barre Syndrome, so it is wise to get your vaccines to prevent them as much as possible. They prevent serious infections, at minimum, which would help prevent Guillain-Barre Syndrome.
I also have the long term variant of Guillain-Barre Syndrome, known as Chronic Inflammatory Demyelinating Polyneuropathy, which is in pharmaceutical remission due to me taking subcutaneous immunoglobulin twice a week for 3 hours each time.
What I am saying is that while all of this sounds rare and devastating, it’s treatable. Not only that, you’re more likely to get Guillain-Barre Syndrome from a bad case of the flu than from a flu shot.
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Is it really $10-15k each additional patient year requires or it's more of "total cost was this much, we divide it by number of patients". Where do this money go to? Fx, with these covid trials, 40000 people in pfizer trial, half a year cost would be $200-300 mln. People presumably weren't paid for this. Of course there's some work by doctors that needs to be paid for, but that can't be this large amount. Also, does…
Ha! You think big pharma likes spending that kind of money on trials? I’ve been a part of those negotiations with the FDA. It costs that much because the company says “we believe a 6 month trial is sufficient to prove both safety and efficacy” and the FDA says “if you want it approved, you need to collect 2 years of data”. Now, $10-15k per patient-year is for a typical therapeutic. And that is an average across globa…
The key differentiator here is the storage requirements (2-8c ‘normal refrigerator’). That’s much more accessible to developing / low GDP countries as opposed the cumbersome and expensive storage requirements of the other two.
The other two current candidates are mRNA vaccines, an approach which hasn't been used in humans before -- looks like the harbinger of a revolution but we have no past experience.
This O/AZ uses the actual spike protein embedded in a simian virus (that does not affect humans and has its own DNA removed). It's possible to generate antibodies to the vehicle (virus) which is why a simian virus is used (humans won't already have encountered it) but also means your own immune system could target the vaccine itself. Loewe speculates that this is why the higher dose was less effective.