The proposed MRP of Rs 1,000 per dose of the vaccine in the private market has also raised eyebrows.
The government procurement price of Rs 200 per dose for Covishield, manufactured by Serum Institute, is higher than what the EU is said to be paying. The EU is paying euro 1.78 per dose (nearly Rs 159) for the Oxford/AstraZeneca vaccine, according to a leaked document posted on Twitter by Belgium’s budget state secretary recently (see box).
Bharat Biotech’s Covaxin government purchase price of Rs 295 has also raised eyebrows as the vaccine is still in “clinical trial” mode and, therefore, lacks crucial Phase 3 trial data, experts pointed out. Globally, drug and vaccine prices have been closely guarded commercial secrets. The pandemic has highlighted the need for greater transparency and equity.
What has surprised public health experts is that the price is higher in India, which has one of the lowest manufacturing costs. “The government should have negotiated a better price and should be offering the vaccine to everyone free. The cost should be around Rs 100 with the economies of scale that kick in. Even with a small margin, possibly (they) are paying Rs 50-60 more. There is no clear commitment from the government yet on vaccinations beyond the priority group, with the implication that the state will have to pitch in,” said S Srinivasan of All-India Drug Action Network, an NGO that works to increase access.
“The government can demand transparency from companies — in terms of cost of production, terms of licensing, and such details. The profit margin cannot be unreasonable — four to five times the public sector price,’’ Leena Menghaney, a lawyer specialising in public health, told TOI.
When contacted, Serum Institute CEO Adar Poonawalla said, “Nobody is giving it for less than Rs 200 on this planet. We have charged a reasonable price, with a small margin. The vaccine at Rs 2,000 (proposed MRP for both doses for private purchase) saves households from huge hospitalisation costs. Going forward, there will be a tendering process in India for further orders” . Serum has set a ceiling price of $3 per dose for low- and middle-income countries for the vaccine to be distributed under the Covax alliance. “Why is there a differential price? Though it is difficult to know the right price as the manufacturing cost is not known, the vaccine can be mass produced at a cheap price. The government could have negotiated a better rate through ICMR, which co-sponsored the trials and supported Covishield’s R&D in the bridging studies done here,” said Dr Anant Bhan, a researcher and a former president of International Association of Bioethics.
The government had on January 12 said that both the vaccines are affordable because they are made in India.