These days it’s rare to read in the media a story with a happy ending designed to comfort our belief that, at least occasionally, we live in the best of all possible worlds. Forbes has offered such an occasion to a self-proclaimed benefactor of humanity, Dr. Albert Bourla, the CEO of Pfizer. (Disclaimer: Pfizer is a company to whom I must express my personal gratitude for its generosity in supplying me with three doses of a vaccine that has enabled me to survive intact a prolonged pandemic and benefit from a government-approved pass on my cellphone permitting me to dine in restaurants and attend various public events.)
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The Forbes article, an excerpt from Bourla’s book, “Moonshot,” ends with a moving story about how Pfizer boldly resisted the pressure of the evil Jared Kushner, Donald Trump’s son-in-law, who had no qualms about depriving the rest of the world — even civilized countries such as Canada and Japan — of access to the COVID-19 vaccine to serve the US in their stead.
“He insisted,” the good doctor explains, “that the U.S. should take its additional 100 doses before we sent doses to anyone else from our Kalamazoo plant. He reminded me that he represented the government, and they could ‘take measures’ to enforce their will.”
Today’s Weekly Devil’s Dictionary definition:
Take measures:
Go well beyond any measured response in an act of intimidation
Contextual Note
Bourla begins his narrative at the beginning, before the development of the vaccine, by asserting his company’s virtuous intentions and ethical credentials that would later be challenged by bureaucrats and venal politicians. “Vaccine equity was one of our principles from the start,” he writes. “Vaccine diplomacy, the idea of using vaccines as a bargaining chip, was not and never has been.”
Some readers may note that vaccine equity was only “one” of the principles. There were, of course, other more dominant ones, such as maximizing profit. But Bourla never mentions these other principles, instead offering a step-by-step narrative meant to make the reader believe that his focus was on minimizing profit. That, after all, is what a world afflicted by a raging and deadly pandemic might expect. A closer examination of the process Bourla describes as well as the very real statistics about vaccine distribution reveals that, on the contrary, Pfizer would never even consider minimizing profits. It simply is not in their DNA.
Bourla proudly describes the phases of his virtuous thinking. The CEO even self-celebrates his out-of-the-ordinary sense of marketing, serving to burnish the image not only of his company but of the entire pharmaceutical industry. “We had a chance,” he boasts, “to gain back our industry’s reputation, which had been under fire for the last two decades. In the U.S., pharmaceuticals ranked near the bottom of all sectors, right next to the government, in terms of reputation.”
Thanks to his capacity to tone down his company’s instinctive corporate greed, Bourla now feels he has silenced his firm’s if not the entire industry’s critics when he makes this claim, “No one could say that we were using the pandemic as an opportunity to set prices at unusually high levels.” Some might, nevertheless, make the justifiable claim that what they did was set the prices at “usually” high levels. A close look at Bourla’s description of how the pricing decisions were made makes it clear that Pfizer never veered from seeking “high levels,” whether usual or unusual, during a pandemic that required as speedy and universal a response as possible.
Thanks to a subtle fudge on vocabulary, Bourla turns Pfizer’s vice into a virtue. He writes that when considering the calculation of the price Pfizer might charge per dose, he rejected the standard approach that was based on a savant calculation of the costs to patients theoretically saved by the drug. He explains the “different approach” he recommended. “I told the team to bring me the current cost of other cutting-edge vaccines like for measles, shingles, pneumonia, etc.” But it was the price and not the cost he was comparing. When his team reported prices of “between $150 and $200 per dose,” he agreed “to match the low end of the existing vaccine prices.”
If Pfizer was reasoning, as most industries do, in terms of cost and not price, he would be calculating all the costs related to producing the doses required by the marketplace — in this case billions — and would have worked out the price on the basis of fixed costs, production and marketing costs plus margin. That would be the reasonable thing to do in the case of a pandemic, where his business can be compared to a public service and for which there is both a captive marketplace (all of humanity shares the need) and in which sales are based entirely on advanced purchase orders. That theoretically reduces marketing costs to zero.
But Bourla wrote the book to paint Pfizer as a public benefactor and himself as a modern Gaius Maecenas, the patron saint of patrons. Once his narrative establishes his commitment to the cause of human health and the renunciation of greed, he goes into detail about his encounter with Kushner. After wrangling with the bureaucrats at Operation Warp Speed created to meet the needs of the population during a pandemic, Bourla recounts the moment “when President Trump’s son-in-law and advisor, Jared Kushner, called me to resolve the issue.” That is when Kushner, like any good mafia boss, evokes his intent to “take measures,” a threat the brave Bourla resists in the name of the health of humanity and personal honor.
That leads to the heartwarming, honor-saving denouement, the happy ending that Bourla calls a miracle. “Thankfully, our manufacturing team continued to work miracles, and I received an improved manufacturing schedule that would allow us to provide the additional doses to the U.S. from April to July without cutting the supply to the other countries.”
Historical Note
Investopedia sums up the reasoning of pharmaceuticals when pricing their drugs: “Ultimately, the main objective of pharmaceutical companies when pricing drugs is to generate the most revenue.” In the history of Western pharmacy, that has not always been the case. Until the creation of the pharmaceutical industrial sector in the late 19th century, apothecaries, chemists and druggists worked in their communities to earn a living and like most artisans calculated their costs and their capacity for profit.
The Industrial Revolution changed all that, permitting large-scale investment in research and development that would have been impossible in an earlier age. But it also introduced the profit motive as the main driver of industrial strategy. What that meant is what we can see today. Pharmaceutical companies have become, as Albert Bourla himself notes, “ranked near the bottom of all sectors.” They exist for one reason: to make and accumulate profit. Industrial strategies often seek to prolong or extend a need for drugs rather than facilitate cures. Advising a biotech company, Goldman Sachs famously asked, “Is curing patients a sustainable business model?” The implied answer was “no.” The greatest fear of the commercial health industry is of a cure that “exhaust[s] the available pool of treatable patients.”
In any case, COVID-19 has served Pfizer handsomely and is continuing to do so. In late 2021, the Peoples Vaccine Alliance reported “that the companies behind two of the most successful COVID-19 vaccines —Pfizer, BioNTech and Moderna— are making combined profits of $65,000 every minute.” Furthermore, they “have sold the majority of doses to rich countries, leaving low-income countries out in the cold. Pfizer and BioNTech have delivered less than one percent of their total vaccine supplies to low-income countries.”
At the beginning of the COVID-19 “project,” Bourla boasts, “I had made clear that return on investment should not be of any consideration” while patting himself on the back for focusing on the needs of the world. “In my mind, fairness had to come first.” With the results now in, he got his massive return on investment, while the world got two years and counting of a prolonged pandemic that will continue making a profit for Pfizer. At least he had the satisfaction of putting the ignoble Jared Kushner in his place.
*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Fair Observer Devil’s Dictionary.]
The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.
