The iPhone, obviously. The Tesla Model S. And Disney+. There have been some hugely successful new products over the past couple of decades. There is one more that takes its place in the same league: the Covid-19 vaccine. Judging by the results released this week, the market is worth at least $60bn (£43bn) annually and will double or triple in size over the next couple of years.
Right now, the American pharmaceutical giant Pfizer looks to have that just about sewn up. Britain's AstraZeneca is ready to throw in the towel , and hardly anyone else is even in the race .
But hold on. There is still plenty of life left in this contest. Why? Because we are still only in the early stages of collecting all the evidence on effectiveness ; because new variants of the virus are still emerging all the time; and because there are still vaccines in the pipeline that may prove themselves superior. In truth, GlaxoSmithKline or AstraZeneca, among a few others, could still end up the winners.
Rewind 18 months to when Covid-19 was just a health scare in a city in China no one had ever heard of and it would have seemed unimaginable that we would have an effective vaccine for the virus, and even more so a couple deployed globally by the summer of 2021. It is a technological achievement that takes the breath away.
It is also, as it turns out, pretty big business. Pfizer reported this week that sales of the shot it produces with its German partner BioNTech should reach $33bn for this year. The Oxford-AstraZeneca vaccine has been far less successful, knocked back by worries over blood-clotting .
Even so, it racked up almost $700m of sales (at far less per jab, because it is sold at cost) in the latest quarter. Moderna is projecting $19bn of sales for its vaccine in 2021, and while we are never likely to get accurate numbers for the Russian and Chinese vaccines, that is probably a few billion more.
Add it up and this is already at least a $60bn industry. And that, let's remember, is at a time when only Europe and North America have been vaccinated at scale. The whole world needs to be inoculated to defeat the virus – and that makes it potentially a $100bn market. For a comparison, 2020's biggest selling drug was AbbVie's Humira, with revenues of $20bn. In short, the Covid vaccine is a huge product.
It looks as if Pfizer is in pole position. It has trounced AstraZeneca and is well ahead of Moderna. And, of course, it is a brilliantly effective product – one that has already saved tens of thousands of lives. Even so, we shouldn't take its control of the market for granted. Here's why.
First, there is still plenty of data to come. To take one example, a study this week found that the blood clot issues around the Oxford jab had very little substance. There was little difference in clotting between the vaccinated and the control group.
Likewise, another study showed the effectiveness of the Pfizer vaccine declining quite rapidly after six months. Indeed, Israel, the first country to vaccinate, is planning third shots. The important point is this: we are still learning in the real world about the side effects, effectiveness and durability of the different vaccines. That will take one or two years, at least. Our final answers may not be the same as our first ones and other vaccines may prove as good or better (and of course the AstraZeneca one is far, far cheaper).
Next, variants are emerging all the time . We have already been through the Kent, the South African and now the delta variant, and there could easily be more on the way. At the rate Covid mutates, we could run out of names. Different vaccines may be more effective against some variants than others. Or it may well take a mix of vaccines to defeat them – there is already some evidence of that for the delta variant, although we will need more evidence. As that happens, space will open up for other treatments.
Finally, new and better vaccines may come along. Both the Pfizer and AstraZeneca shots are superbly effective, and far more so than the Russian and Chinese versions (which, from the evidence of the countries that have used them, are disappointing). No one is really holding out great hopes for the Cuban vaccine, although with a reported 92pc effectiveness, you can never tell.
But there are some more promising candidates out there. The European Medicines Agency has started a rolling review of the Sanofi-GlaxoSmithKline candidate, and it could be approved by the end of the year. It may well be very good and Sanofi's involvement will mean it has plenty of support in the European Union. The Novavax vaccine may well be approved at the same time and has promising results. And there may well be other candidates in the labs we know very little about yet.
True, it is hard to dislodge a product as dominant as Pfizer's jab. Most of us will prefer to take something we know is 90pc-plus effective against a deadly disease rather than try something new. A lot more is at stake than checking out a new brand of beer. Even so, it is possible to dislodge a top-selling medicine – it has happened lots of times in the pharmaceutical industry.
In reality, with the virus still circulating, and mutating, for many years, Covid vaccination will be a huge market for most of this decade. And while Pfizer has taken an early lead, the battle has plenty of drama ahead – and the UK's AstraZeneca and GSK are still in the game.
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