In our little corner of the world, we’re surrounded by giants in healthcare: the National Institutes of Health, the Food and Drug Administration, and colleges and universities filled with top-notch labs and researchers. And for someone like me, who has investigated diseases and developed vaccines for decades, there’s no better place to live.
Early in my career, I worked in Cuba (where I was born and raised) and would collect blood samples from people with Hepatitis C. At the time, it wasn’t even called Hepatitis C; no one quite understood what it was. I talked with doctors who had patients with significant liver damage. Years later, my father-in-law would die of Hepatitis C. I have seen how prevention can halt tragic consequences, and I’ve been proud to play a part in developing those preventive measures.
Right now, I head up a small company that’s working on creating a vaccine to protect babies against rotavirus and norovirus. Both cause diarrhea in small children, which can emperil their health and lives.
Before the early 2000s, when a rotavirus vaccine began to be widely used in the US, it’s estimated that about 60,000 American children were hospitalized every year with the disease. You may have had a child who ended up in the ER for exactly that reason. In 2010, The New England Journal of Medicine noted that rotavirus was the “most important cause of severe childhood diarrhea globally and annually cause[d] more than half a million deaths among children under 5 years of age.”
But rotavirus vaccines changed everything. Both in the US and around the world, hospitalizations and deaths from rotavirus plummeted. Millions of kids have now been vaccinated against rotavirus.
Norovirus, by contrast, is famous as the scourge of cruise ships, making hundreds of guests suffer through stomach pain and diarrhea. And many parents know it as a threat to their newborns and young kids; it sends tens of thousands each year to the ER.
Our team came up with a way to piggyback a vaccine for norovirus onto a rotavirus vaccine. If we’re successful, then, with one vaccine, we’ll protect tens of thousands of children from both viruses.
I’ve joked with my researchers that the 2011 movie “Contagion,” starring Matt Damon and Gwenyth Paltrow, marked a setback for virologists like us because the movie depicts lab work almost immediately translating into vaccines. In reality, it takes a long, long time to develop something worthwhile. Probably a decade. And, for most researchers, that’s a big chunk of their lives to devote to one project. But it’s worth it.
I wanted to share with you, as a neighbor, that our whole community is really involved in this quest to conquer norovirus. Because the money to fund my work comes from biotech funds which, in turn, work for institutional investors that include pension funds. So there’s a chance that anyone reading this - if they have savings in a pension fund - could be making my work possible. Thank you.
Now I know that’s not a donation. People invest because they want to retire securely. They count on our vaccine to someday be profitable, which it can be. Fortunately, it will still be affordable to families, thanks to insurance.
Most medicines go generic about 14 years after they launch, which is enough time for investors to make money from their investment. Then the medicines often become very inexpensive, saving money for all of us by lowering what we pay for insurance.
But policymakers recently passed a law that worried me and might worry you. The Inflation Reduction Act of 2022 imposes price controls on some drugs 9 years after they launch, a much shorter period than the 14 years that patents and prior laws allowed. (A new bill, SMART, proposes imposing price controls on all drugs just 5 years after they launch.)
That might sound good, except no one is going to want their pensions invested in companies that won’t be profitable. Patents allow medicines to have about 14 years on the market because it takes some time to make enough money to justify to investors the risk and expense of developing a drug. The reason that insurance exists is to make these medicines affordable to patients. When they aren't because insurance demands high out of pocket costs, we need to fix insurance.
Most of what we spend on insurance, our premiums, actually goes towards hospitals, where costs keep rising. Only about 10 percent is spent on existing branded medicines, which spurs the development of new drugs. Since medicines can keep us out of hospitals, they’re an investment that saves money.
The Inflation Reduction Act changes the way our community works together to create new medicines, making it unappealing for anyone to invest in new medicines. That means that we’re likely to spend a lot more on hospitals, while our children continue to suffer from conditions like norovirus.
I don’t think many people realize that their money is funding work like mine. Others don’t realize that we rely on insurance to make medicines affordable to patients. Our team certainly isn’t working on this vaccine expecting that any child will have to go without it. We all get angry when people are denied a medicine they need.
What the Inflation Reduction Act gets right is lowering out of pocket costs for seniors and making sure that some drugs, called biologics, really do go generic when they are supposed to. But cutting off the incentives for investors to fund development of a wide range of new medicines - including cancer drugs and treatments to slow Alzheimer’s - isn’t a good idea.
My hope is that we all recognize the value of continuing to work together through insurance, investing, and research to keep coming up with affordable medicines that keep us all healthy and out of hospitals. Maybe we can hear from others in our neighborhood who have embarked on similar quests.
And I hope to write a letter to you all someday with an update on how our work is progressing. With continued support from investors, we may someday report data from a clinical trial showing that we are saving children from norovirus. If that comes to pass, it will be a victory for our whole community.
Mario Barro is a scientist and father living with his family in Vienna. He's worked at BARDA and Sanofi Pasteur, been involved in development of medicines for too many decades, and is now the CEO and founder of GIVAX, a company developing a vaccine for norovirus and rotavirus, and is a venture partner with the biotech investment firm RA Capital Management.