Rep. Jan Schakowsky Questions Dr. Anthony Fauci on Zika Vaccine Price at House Energy and Commerce Subcommittee Hearing

On May 23, 2017, Rep. Jan Schakowsky, D-Ill., asked Dr. Anthony Fauci whether he believed the federal government should use "every tool" to ensure that Sanofi charges a fair price for a taxpayer-funded Zika vaccine that is being developed by the U.S. Army and funded by BARDA.

Dr. Fauci responded that he did not believe that the government had the "mechanisms" to guarantee an affordable price, even when the U.S. government and taxpayers have made a "major investment" in the development of a drug.

KEI has separately uploaded a short clip of the exchange between Rep. Schakowsky and Dr. Fauci:

Additional information on the Army-BARDA-Sanofi vaccine collaboration is available at http://keionline.org/zika and http://keionline.org/zika-timeline.

Video of the full hearing and copies of written testimony are available via the House Energy and Commerce Committee website: https://energycommerce.house.gov/hearings-and-votes/hearings/us-public-health-response-zika-virus-continuing-challenges.

A full transcript of the exchange is below.


Rep. Jan Schakowsky (D-Ill.): Thank you. First, let me apologize. I'm the ranking Democrat on a hearing that's going on upstairs, and so I apologize that I missed your testimony. Given the importance of developing a Zika vaccine, hundreds of millions of federal dollars have been obligated to conduct clinical trials. I understand there's 32 vaccine candidates that are being studied in the U.S., and the U.S. government has helped to partially or fully fund a number of those vaccine candidates. So, it's my understanding also that the drug manufacturer Sanofi has received over $40 million from the U.S. Army [sic] to conduct a phase 2 trial for one of the vaccines, with the possibility of accessing up to 130 million more in taxpayer funding for phase 3 trials. All told, nearly 300 million of federal dollars have been obligated for vaccine development to date. So, stick with me for a minute. While it's critical that we develop and manufacture an effective vaccine to combat Zika virus, it's just as critical that the vaccine be available to everyone who needs it. I'm also very concerned that Sanofi recently rejected the Army's request for a "fair" price for the vaccine. Earlier this year, I led 10 of my House colleagues in sending a letter to the Army raising concerns about their plans to issue an exclusive license to Sanofi for the vaccine that U.S. taxpayers helped develop. In addition, Governor Edwards of Louisiana, one of the states that has hit largest, hardest by the Zika virus, sent a letter to the Army that raised similar concerns. I'd like to ask unanimous consent to enter both of these letters into the record.

Rep. Tim Murphy (R-Penn.), Chair: Can we review them, assuming it would be okay without objection?

Rep. Schakowsky: Okay.

Chair: Thank you.

Rep. Schakowsky: Dr. Fauci, given the enormous investment of taxpayer dollars into the development of a Zika vaccine, do you agree that we need to use every tool of the federal government to ensure that the vaccine is affordable?

Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases (NIAID): The answer to that question is yes, but it is a complicated issue, Congressman [sic], as you well know, because we don't really have the mechanisms to influence pricing of a product, even products in which we make a major investment for the development of. Certainly, we feel as scientists and public health officials that the work that we do in the development of vaccines should be available to everyone and anyone who needs it. So, if you're asking is that the answer to the question, it is absolutely, I feel, that we need to do that. Whether or not we have mechanisms in place right now to guarantee that, I don't think we do.

Rep. Schakowsky: But it is true, isn't it, that vaccines are most effective when the vast majority of the public is immunized, so if the - if it's priced out of reach of many, won't this be a problem in getting control of the whole disease?

Dr. Fauci: Yes, it would, obviously, it would be. I mean, if you cannot vaccinate the people who need it, and you correctly said that a vaccine, particularly in an outbreak situation, is that the more people that get vaccinated, the more control you get over the outbreak. So, I agree with you that it's essential to the extent that we can do that, to vaccinate, where appropriate, as many people as we possibly can

Rep. Schakowsky: It's just a big concern to me, since the Army actually said that they would not guarantee a fair price, and yet we're prepared to use taxpayer dollars to lay out perhaps as much as $130 million …

Dr. Fauci: Right.

Rep. Schakowsky: … to them, potentially without any ability to control that. Let me just raise another concern. It's important, also, to remember the damaging impact that the repeal bill that just passed the House and — of Obamacare — and the Trump budget would have on Medicaid, and our ability to respond to public health crises, like another Zika outbreak. The per capita cap included in both Trumpcare and the Trump budget would make it nearly impossible for states to expand services in the number of eligible individuals during a public health emergency, as Michigan did during the Flint Water Crisis. Moreover, under a per capita cap there is simply no way any state could provide access to a high-priced drug to all of its Medicaid beneficiaries. And, depending on how the final Zika vaccine is priced, Medicaid programs could already face challenges in trying to pay for the drug and those problems would only be compounded if Medicaid was drastically restructured as Republicans have called for. As this Committee investigates the public health response to the Zika virus, and considers how we might prepare for future challenges, it's critical to remember the important role that Medicaid has paid in responding to public health emergencies, and the devastating effect that Republican proposals to cap Medicaid would have on our ability to respond to those emergencies. I yield back.