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Price delays slow the launch of a vital vaccine in India | India News


As major countries like the US and China are rushing to vaccinate their populations with rapidly approved vaccines, tens of millions of doses prepared for India are in storage despite being licensed for use.
While distribution to other nations began shortly after approval with pre-signed pricing agreements, New Delhi and the Serum Institute of India Ltd., the world’s largest vaccine manufacturer by volume and a local partner of AstraZeneca Plc, have become involved. in months of bargaining behind closed doors. doors and have not yet signed a formal supply agreement. That has left at least 70 million vaccine doses in limbo despite the urgent need in a country facing the world’s second-largest outbreak.
On Sunday, Serum billionaire CEO Adar Poonawalla said Indian officials had “verbally” agreed to buy 100 million doses at a “special price” of Rs 200 ($ 2.74) per injection, below the price of between 4 and 5 dollars that was given to the UK. government. Then the company wants to sell vaccines privately to individuals and companies at a marked cost of Rs 1,000 within two to three months.
The Indian government may be looking to pressure Serum to lower its prices, as seen in its controversial decision to green light a rival vaccine developed by a local company that is still recruiting volunteers for end-stage testing, according to Abhishek Sharma. , Jefferies analyst.
The confrontation has cost precious time in a country where infections have crossed the 10 million mark and reflects the tension between the public interest and the private profit of pharmaceutical companies who want to recoup their pandemic investments quickly.
While the richest and most developed economies have mostly avoided price disputes in their implementations so far, the question of how much vaccines should cost in the midst of a pandemic that is killing more than 10,000 people every day in the whole world gets bigger as the distribution spreads to the developing world. .
For Prime Minister Narendra Modi, every penny spent on the price of a vaccine in a nation that is home to more than 1.3 billion people will have serious financial consequences for his administration.
“When buying in bulk, there is obviously the advantage of being able to negotiate the price,” Randeep Guleria, a member of Modi’s working group for Covid-19 management and director of the Indian Institute of Medical Sciences, said in a release. interview on Monday. He added that negotiations are ongoing in the framework of procurement policy and “obviously they can also decide what the market price should be later.”
Guleria said the purchase agreement would be signed “at any time.” India is ready to roll out Covid-19 vaccines within 10 days of their approval by the drug regulator, Health Secretary Rajesh Bhushan told reporters at a briefing on Tuesday. It did not say whether a price or supply agreement had been signed.
The UK took five to six days to deploy the first jabs after granting emergency nods to the Pfizer Inc. and Astra-Oxford vaccines.
India tests vaccine delivery system with national dry trial A healthcare worker opens a freezer during a Covid-19 vaccine trial in Delhi on January 2.
In October, people with knowledge of the matter told Bloomberg that New Delhi had set aside around 500 billion rupees for vaccination efforts, estimating a total cost of around $ 6 to $ 7 per person. A spokesman for the Indian Ministry of Health could not be reached for comment.
“The government doesn’t hand over money to the private sector that easily,” said Ramana Laxminarayan, founder of the Center for Disease Dynamics, Economics and Policy, from the Indian capital. “They are just good at playing because they have budget pressures; bureaucrats, if they come back with a bad deal, the minister will send them back and tell them ‘get me a better price.’
India’s blueprint for vaccination states that 300 million people will be inoculated in the first stage of deployment, starting with health workers, followed by police personnel and soldiers, and then those with comorbidities and individuals. over 50 years. Guleria said this process would take three to four months to complete.
Delhi Airport Cargo Terminal Vaccine Handling Systems Tour Workers transport a temperature-cooled container at Indira Ghandi International Airport in New Delhi on December 22, 2020.
Local officials across the country have been asked to compile priority vaccination lists, but the preparatory work appears uneven, based on interviews with doctors and local representatives. Some localities also appear to be preparing to administer two different vaccines at the same time.
Although AstraZeneca’s injection has been proven in global trials and has received an emergency license from UK and Indian regulators in recent days, Hyderabad-based vaccine developer Bharat Biotech International Ltd. has yet to start. to analyze data from Phase 3 trials, but was also controversial. granted limited-use approval by the South Asian nation over the weekend.
“There are several vaccines that will be used,” said Amit Thadani, a surgeon at Nirmaya Hospital in Mumbai. “They’re going to assign a particular type of vaccine to be used only in one district, so if there is a problem, it’s easy to identify which particular vaccine is causing it.”
The serum, which has a deal with AstraZeneca to produce at least 1 billion doses, has already lowered an initial production target of 100 million for December due to slower-than-anticipated approvals.
Poonawalla began publicly broadcasting the discussions about potential vaccine prices in September, which some health experts saw as part of a lobbying effort.

In Sunday’s interview, Poonawalla was optimistic that a written agreement would soon be reached in a couple of days. “We’ve already packed it, we just have to truck it through the states and receive it,” he said, referring to the 70 million doses the company has ready to distribute.
‘Rushed approval’
Meanwhile, India’s decision to grant Bharat Biotech’s Covaxin restricted approval despite the lack of final data on the test’s efficacy has puzzled observers. In August, company president Krishna Ella told a conference that his vaccine would be cheaper than bottled water, costing less than half of what Serum offers the AstraZeneca vaccine.
“The hasty approval of Covaxin, even as an alternate candidate, is driven primarily by the Indian government’s business considerations,” Sharma, a Mumbai-based health analyst at Jefferies, said in a report Sunday. If Covaxin “can demonstrate efficacy in the coming months, subsequent vaccines will have to compete both on price and efficacy.”
The rapid approval of Bharat Biotech may also be because India does not want to be in debt to a single vaccine manufacturer.
In an echo of a long-standing debate about the role of private pharmaceutical companies, concern is already growing that Serum’s position as the only national supplier of a vaccine that could save lives is too powerful.
Outside of India, AstraZeneca only supplies to governments and has not yet signed private agreements with companies or individuals. However, Serum wants to access the higher margin private market in a few months, where it plans to increase the injection price five times, under Poonawalla’s shared pricing plans.
First engine
The proposed price of Rs 1,000 per dose is “absolutely a price hike and leverage its position as the first to act,” said Malini Aisola, the New Delhi-based co-coordinator of the All India Drug Action Network, a watchdog. Of the health. “Personally, I don’t think they should give approval for private use at this time.”
But for the well-to-do in India’s stratified society, waiting for the Byzantine public health system to distribute doses is not an option.
A large private bank is awaiting guidance on dates and benchmark prices from the government that would allow it to consider purchasing the vaccines directly from manufacturers, according to officials at the lender, who asked not to be named because the deliberations are private.
For now, Serum is still waiting for its first order from the government. Poonawalla said that India first needs to secure enough vaccines for those most in need. “If we were to sell it however we wanted, it makes logical sense that some of the most vulnerable people would miss out,” he said.
New Delhi also knows that the vaccine manufacturer will not be able to easily move these huge volumes elsewhere.
“India buys a lot of vaccines from the Serum Institute every year and they know how to play this game,” Laxminarayan said. “India can wait a little longer, but for Serum it will not be that easy for them, the government has ways of leaning on it.”

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