Lack of commercial availability of Swine Flu (H1N1) Vaccine

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Dr Charlie Easmon MBBS MRCP MSc Public Health DTM&H DOccMed
Medical Director www.numberonehealth.co.uk
Email cahrlie@numberonehealth.co.uk


When is a customer not a customer? When is a pound not a pound? A dollar not a dollar? When a drug company says so?
When I first became aware that drug companies were producing a pandemic vaccine, I was excited. When I heard, on the grapevine, that pandemic vaccine was only available to government I, at first, accepted that.
However, on reflection, the decision by the drug companies to make no stocks of pandemic available commercially seems to me absurd, anti-competitive and unfair.
Does Ferrari only sell to Arabs? (no offence intended to Arabs)
My anger and frustration comes on behalf of my staff, friends, colleagues and clients.
Private health care in the UK is at least 10% of all healthcare. The private sector are efficient deliverers of vaccine services for both private and the National Health Service (NHS). The private sector can facilitate the access of pandemic vaccine to vulnerable groups such as pregnant women and those with pre-existing conditions. The private sector can administer vaccines in the workplace and so help 1) the UK economy by staff not having to take time off work and 2) General Practitioners by reducing the burden on them.
I tried to assess the rationale of the drug companies for not selling to the private sector.

1) Had the UK government banned them from selling it to the private sector?
Email exchanges with the Department of Health (DH) confirmed that this is not the case.

2) Lack of production capacity?

Possible, but in my view not an acceptable excuse for lack of communication on such an important issue. If you can produce several million doses for a key client (government), you can still make provision of a few thousand or tens of thousands for the private sector.


3) Legal issues

I struggle to see what these would be. The vaccine is safe and has European medical regulatory licensing. Private practitioners have appropriate levels of risk insurance.

4) An internal policy decision

This seems to be the likely reason but by whom and with what decision matrix? There is no transparency about this. In my experience the drug company staff themselves are confused by the policy and some do not understand or support it.

My message to the drug companies on this issue is that such an important policy decision should be transparent and communicated to private clients in a way that they can at least respond.

There is a real risk, in my view, of damaged customer relations and life has been made more difficult for the field force (reps) of the drug companies. These reps normally spend the whole year trying to SELL products to us. Suddenly for the one pandemic in world history for which there is a vaccine, the private sector is no longer a customer!

I hope that colleagues will take up this cause whether they agree with me or not.

Incidentally, I was amused by one incident. The drug company mantra is ‘we only sell to government’. I then got a call from a government asking for 400 doses for their UK-based embassy staff. The response – nothing!

So, how do I feel that the drug companies could have handled this better? They could have communicated early to private providers along the following lines:
Re pandemic flu vaccines, the vast majority of our stock will go to government. We believe that this is the right thing for us to do. However, we have not forgotten our private clients and have made a small allocation of X doses available. Clearly, demand will outstrip supply for these few doses and we will allocate on rationed basis (for example, usage of our other vaccine products in the private sector).



Finally, as a private practitioner I respect the NHS and believe that the vast majority of the vaccine should be administered from that source with help form the private sector where necessary. However, I also believe in choice, and it grates to have that choice taken away with no proper redress.