Dr Graeme Jarvis: Covid-19 vaccine procurement: Counting our blessings
OPINION:
New Zealand should be counting its blessings that MBIE took a portfolio approach to vaccine procurement rather than relying on the standard Pharmac procurement model.
Otherwise, we would likely be in a situation where rolling out any vaccine would be a 2022 dream – not a 2021 reality.
MBIE’s portfolio approach was bespoke and fit-for-purpose for the pandemic response and in actuality -in line with the approach of other countries.
Despite what has been said by some media commentators – it’s important to understand that Pharmac processes only suit a non-pandemic situation. Furthermore, Pharmac and its processes have no time limits on decision-making and it and New Zealand are seen globally as a slow follower country – not a fast-mover.
That is part of the reason why there is a Pharmac Review process going on – looking at the clear issues with its timeliness of decision-making on modern medicines and vaccines. Indeed, this decision-making is on average twice as slow as other comparable OECD countries – 2 years (659 days) versus 9 months (273 days) respectively.
That slowness of commercial decision-making is compounded by the fact that most cost-effective modern medicines are not publicly funded at all here. As a result, New Zealand ranks in last place out of a list of 20 comparable high-income OECD countries as regards the procurement and availability of cost-effective modern medicines and vaccines to respective public health systems.
Furthermore, Pharmac decision-making processes for vaccines and other modern medicines do not factor in economic benefits and societal and wellbeing benefits (e.g. ability to return to work, quality of life). This is in stark contrast to our other developed peer OECD nations. This means that in all likelihood – had we been
using the Pharmac procurement approach – all the COVID-19 vaccines would have failed the grade – just like a lot of other cost-effective modern medicines going through the process here in New Zealand.
By allowing MBIE to lead the COVID-19 procurement process, New Zealand
has gained more than one vaccine and by utilising a broader economic and societal cost-benefit assessment approach, this has allowed the Government to acknowledge that New Zealanders lives are worth the investment required to obtain the vaccines.
Although we agree with some who state the vaccine roll-out and supply
agreements could have been faster, we believe this is not due to the MBIE-led procurement process, but rather New Zealand’s reactive approach to discussions with vaccine-producing companies right at the beginning of the COVID-19 pandemic.
Other countries worked collaboratively with the industry to support research, development and manufacturing of COVID-19 vaccines. New Zealand did not.
Those countries, including the UK, the EU, USA, Australia and even lesser-known places like Kazakhstan have invested in multiple different COVID-19 vaccines to ensure every person who needs a vaccine can get one.
As noted above, New Zealand has taken a similar approach with advanced
purchase agreements for four COVID-19 vaccines. It has secured more than enough vaccines for every person in New Zealand and our Pacific neighbours. So the country is not solely reliant on a single vaccine, and the government has choices if it wishes to take
them.
In contrast, having a single version or sole supply of a medicine is the standard procurement process at Pharmac, but it has frequently led to supply shortages and out of stock situations. This causes the health system and patients to face issues. These are problems not seen elsewhere in the developed world during normal
times, let alone in a pandemic.
Indeed, no other OECD country follows this sole-supply approach and for good reason – patient safety and wellbeing and health system efficiency is at risk if a sole supply goes AWOL.
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It begs the question – would you want that much reliance on a single COVID-19 vaccine supply? Don’t worry… it’s a rhetorical question, because thanks to MBIE, New Zealand has multiple vaccine supply options open to it.
However New Zealand, like other nations, is currently facing a growing outbreak of the Delta variant of COVID-19, and vaccinating our eligible population is an extremely important undertaking and a vital part of our public health response now.
Our member companies involved with the COVID-19 vaccine supply will continue to do everything they can to deliver the vaccines to New Zealand, the successful stockpiling, distribution and vaccination roll-out is, however, the Government’s responsibility. One we are sure it will rise to, and we hope, deliver upon.
– Dr Graeme Jarvis is chief executive of Medicines New Zealand, the industry association representing research-based biopharmaceutical companies operating in New Zealand. It advocates for the benefits of modern medicines as part of a high-quality public health system, and does not fund any patient groups or government entities.
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