Price Controls Could Slow the Race to an HIV Vaccine

Johnson & Johnson recently announced that its experimental HIV vaccine failed to prevent infections in clinical trials. The news comes as a big disappointment to public health activists and patients around the globe.

But there's still cause for optimism. Moderna just started testing its own HIV vaccine, based on the same mRNA technology used in its highly effective COVID-19 shot. And Johnson & Johnson continues to work on a different HIV vaccine. If one of these inoculations proves successful, the plague that has taken 32 million lives so far could finally end. 

We're living in a Golden Age of medical innovation. The mRNA platforms developed by companies like Moderna and Pfizer could revolutionize health care — so long as policymakers don't inadvertently hamstring innovators.

For a drug developer, taking on any new vaccine project is a monumental risk. Inventing a vaccine from scratch costs more than $1 billion, on average. No company has successfully created and sold an HIV vaccine on a mass scale, meaning that none of the companies that have invested in these projects — among them Merck, Sanofi, and GlaxoSmithKline along with Johnson & Johnson — have been able to recoup funds spent on research and development.

Yet companies like Moderna and J&J continue investing because they know that if they're successful, they'll have a tectonic impact — on the millions of people who never get HIV as a result, as well as on their own bottom lines. Creating a life-altering drug or vaccine offers rich scientific and philosophical satisfaction, and even a place in the history books. But this sort of long-haul research cannot attract investment unless it offers the chance of a financial payoff, too. 

For this, the companies that create vaccines must be able to sell their products in a functioning marketplace. There would be little incentive to spend billions of dollars inventing new medicines if those who fund drug research knew — from the outset — that they'd never earn back their upfront investments.

Yet many Democratic lawmakers are pushing to include a measure that would impose price controls on prescription drugs in the colossal reconciliation bill making its way through Congress. The effort would allow the federal government to set drug prices in Medicare and then extend those prices to the entire marketplace.

This could have devastating consequences for all drug research and development, including the experimental HIV vaccines.

If firms like Moderna and J&J — along with all the start-up biotech firms nipping at their heels — come to worry about ever earning back their upfront investment costs, it'll be difficult to continue funding clinical trials, let alone raising new capital for new research projects. 

Such a blow to innovation would be especially disconcerting given the extraordinary potential of mRNA. Not only could mRNA finally lead to the elusive HIV vaccine, it could also pave the way for vaccines for other common viruses, the flu, and even cancers. 

Progressives would be justifiably livid if Republican lawmakers were rushing forward with a plan to slash public funding for HIV research. But right this moment, Democrats are rushing forward with a plan that would slash — if not completely eliminate — private-sector funding for HIV research. Since it’s only the private sector that brings new medicines to market, this disconnect is outrageous. 

We need to keep funding innovative medical technologies. Introducing price controls would seriously jeopardize investment in research and development, and prevent life-changing and lifesaving medicines from ever making it out of the lab.

Brandon Ellyson is a gay rights activist who founded Out for Liberty, an LGBTQ+ community of libertarians.