Cui bono, i.e., to whom for the benefit, or why the covid vaccine is a gift from heaven for selected companies and their co-workers.
I have spent almost twenty years in the executive management of pharmaceutical companies focusing on sales and marketing, for example in Pfizer, Teva, Johnson & Johnson. I created local and international marketing strategies. I acquired professional support from the so-called Opinion leaders, in modern words influencers - doctors who spread the "right" ideas and which others listen to and follow. And many other projects. I want to show you how pharmaceutical marketing can work if it has massive resources and is linked to politics. Consider this text is a general preview because it cannot be generalized. However, the covid vaccine is an excellent example showing main principles.
To begin with, my opinion on the today’s problems of the pharmaceutical industry and how could industry solve them:
THE PURPOSE OF THE PHARMACEUTICAL COMPANY IS TO MAKE PROFIT! Pharmaceutical companies are commercial companies as in other industries, to which there is nothing wrong. The purpose is therefore primarily to ensure a profit for investors, owners, and shareholders. What about patients, you ask? Patient is a word you will hardly hear at a sales meeting of many pharmaceutical companies. But you will certainly hear words like sales, potential, market share and profit.
Gone is the time of "UNIQUE GOLD" MOLECULES, MASSIVELY USED AND PAID BY "GOLD". Patent protection has expired, and companies are being forced to cut prices. In addition, over the next 10 years, patent protection will expire for other drugs, each of which has generated annual sales of billions of dollars.
THERE IS A FEW REALLY INNOVATIVE DRUGS LAUNCHED PER YEAR, and companies are fighting for the rights to such drugs, which reduces profits. These are further limited by the current system of regulation, reimbursement, required proof of the efficacy and cost-effectiveness of new medicines and promotion and marketing limitations of new medicines. Regulators are reducing reimbursement. The result is lower prices and thus profits.
THE DEVELOPMENT OF A NEW DRUG IS A RISKY LOTTERY. Drug development takes approx. 10-15 years, and the cost can reach hundreds of millions of dollars. In addition, of the 100 "promising" molecules, lower units enter the approved drug phase. It is therefore necessary to find ways to reduce these costs. One option could be to significantly reduce research time.
DOCTORS AND FREQUENTLY REFUSE TO COOPERATE Most doctors can handle the pressure and treat according to the patient's needs and interest, not according to the requirements and needs of the drug manufacturers. It would be very beneficial for pharmaceutical companies and often hospitals to eliminate the decision-making powers of doctors.
The inability to promote prescription-only medicines (hereinafter Rx) to the public, which is valid in Europe. (eg US has different legislation). This limits the marketing reach to the end user. It would be ideal to break this barrier and promote Rx medicine to the public.
THEREFORE, IT IS NECESSARY TO CREATE NEW SOURCES OF PROFIT. The covid vaccine appears to be an excellent candidate. Ideally mandatory, with regular revaccination, expensive for users and cheap to produce with a guaranteed price and sale. No responsibility for side effects. With secret price and distribution channels. Its application will not be decided by individual physicians, but by state institutions. Production costs can be significantly reduced by shortening the testing time and reducing the complexity of the tests. However, this would be unacceptable under standard conditions. It is therefore necessary to provoke a crisis that will justify such an approach.
Covid vaccines are conditionally approved without completing phase 3 studies, even though the technology is new and has not yet been massively used and tested. Such a brutal breach of the defense mechanisms set up to guarantee the safety of medicines has not yet been there. Approval, albeit temporary, is a decision to enter the market that is very difficult to revoke. Especially in this case. This creates the first wave of profit. Due to the lack of information on adverse reactions in the medium and long term, it may be of interest to create many patients who develop complications after administration of the vaccine. And such patients will need to be treated. So, a potential second wave of profit.
HAVING ALMOST UNLIMITED "MARKETING" WHAT TO DO TO MAKE ALL THIS HAPPEN? BUDGET”.
- INVENTING IDEAL DIAGNOSIS, or there is no healthy person, just little tested ones.
Today's medicine is a slave to laboratory tests. This procedure creates a fundamental potential for the sale of "preventive" solutions. "Healing" the healthy is, of course, more cost-effective than treating the sick.
We need to move clinically healthy people to the category of "sick" people who need treatment. Thus, it is necessary to skip the phase of solving clinical symptoms and elevate the laboratory examination to the position of diagnostic truth. It is necessary to make clinically healthy people sick.
Where "illness" depends on positivity or negativity, it is necessary to ensure that as many people as possible get positive. Therefore, set the diagnostics correctly. For PCR assays, determine the exaggerated Ct value. This will create many patients and provide alarming data for a pandemic.
But the clinical picture is also important. Ideally common symptoms, such that everyone can observe themselves. Fever, runny nose, cough, tiredness, joint pain. To be able to confuse the influence of other pathogens. Therefore, it is necessary to limit the differential diagnosis. So that all severe conditions and complications can be presented as covid.
- MAKING PROBLEM VISIBLE AND CREATING THE NEED TO SOLVE THE SITUATION, arousing fear, and finding allies
In the case of vaccines, there is no battle between good and evil. For other medicines, at least some guarantee of patient protection is medical agencies, state institutions and regulators. In the case of vaccines, there is the GAVI organization, which brings together those who should be in opposition. WHO, UNICEF, the World Bank, the Bill and Melinda Gates Foundation, national governments, private sector foundations, vaccine manufacturers, professional and community associations, and religious societies work together on vaccination programs.
A system where all these players are involved allows for virtually unlimited activities. It is possible to eliminate control mechanisms, opposite medical opinions, to manipulate the public, all in the name of profit. Everyone earns. Diagnostic kits, protective aids do not compete with medicines, and those who earn many on them will also work together to keep the situation under control. Alternatively, politicians could be motivated by commissions from applied vaccines. If politicians get involved in the "campaign", then there will be no need to worry about possible intervention by control authorities, and even drug approval agencies will be under pressure to approve the vaccine for use even in case of doubts.
In addition to political support, it is necessary to have experts for whom politicians can hide behind and who will be as loyal as possible. It is ideal to create your own "experts". What about the fact that they know nothing about the issue or deal with it theoretically. It does not matter. Collaborating media will help create a camouflage of expertise. If some experts have the stigma of unclean cooperation with pharmaceutical companies, the better. It is better to negotiate with them.
The average citizen is used to trusting the authorities and does not examine their competence. And we will then create scenarios, methodologies, and instructions what to should these artificial authorities say, and the media will give it the right emotional charge. We must not give opposition experts room, because an expert discussion is inadmissible because it would reveal the truth and ruin the plans. Of course, we will erase inconvenient information and introduce harsh censorship. We will create a negative and scary media campaign. Fear alone, will not be enough. People must be scared and unsafe before being offered a remedy in the form of a vaccine. Otherwise, they wouldn't want it.
- THE NEED TO SHOW THAT "IT WORKS AND IT'S SAFE", even if it may not be true.
But before selling on a large scale, especially for a new therapeutic variant, it is necessary to have a sample and practical proof of functionality. Studies are not enough; it is necessary to have evidence from everyday life. Ideally for a group that is perceived as at risk. That's right, either seniors or children. The children would not pass, so we will choose seniors. If the use of a solution in this group is medically defensible, the better. This part gives the rest of the manipulation legitimacy that can be used for subsequent promotion.
- Correct presentation of light at the end of the tunnel YOU WANT TO LIVE NORMALLY, WE HAVE A SOLUTION FOR YOU - THE FINAL SOLUTION.
As part of the promotion of the vaccine, possible other solutions need to be questioned and eliminated, so to give the impression that only the vaccine will work. It is important to eliminate everything that could be effective, but especially what is free or cheap. If the "apocalypse" has no other solution than the vaccine, people will want it even if the studies are not completed. Unfortunately, despite censorship, opposite statements and data raise the doubts about safety and efficacy of vaccine. People doubt it, because they already see a clear contradiction between the real situation and the media image and professional and political proclamations. Then repressive action will need to be even more strict..
- Market share protection - EVERYONE HAS ADVERSE EFFECTS, BUT COMPETITION HAS MORE OF THEM.
The winner takes it all, they say. Every day without competition with an exclusive or dominant market share means huge revenue. It is strange that at an early stage there was information that one of the vaccines caused blood clots, in production site of other authorities found mold and stains on the floor, the vaccine from the east is unacceptable. It is necessary to find a defect in the competition. It doesn't matter what it is and how serious it will be. Ideally, if one of the governments decides not to continue using the competitors vaccine. It is necessary to evoke fear of competing products, ideally among the end consumers.
- Expanding market potential LET THE BUSINESS SPIN. It is necessary to find ways to justify or force the use of as many people as possible. Now is the time to experts that will show how great and safe the drug is. It is not at all important that these recommendations are in direct conflict with the vaccine dossier (Summary of Product Characteristics). We do not address suitability, need, safety. We need to apply doses. And what if the vaccine turns out not to work, so we thought? That the practice denies the declared high efficiency presented in conditional registration? That the vaccinated people get sick again and transmit the virus? We will turn the situation into an opportunity. We will apologize for some force majeure that we could not influence and offer a solution in the form of another dose. Maybe more doses. The pressure needs to be increased so that more and more doses are still given. Any side effects are downplayed. It is concealed that only a fraction of the real side effects is reported to the system. In addition to getting the product repeatedly to as many people as possible, how can we expand the market? We do have animals here. Even the "need" to vaccinate animals can be justified. All you must do is dust off the original theory of transfer from bats and apply it to other animals. Carriers, reservoirs of mutations. It doesn't matter what nonsense comes up. Another few million doses sold are within reach.
- Business is up and running, let's focus on something else WE HAVE REACHED THE TOP, LET'T LET IT GO OWN WAY. When we reach a situation where the use of our product becomes an accepted standard, it is time to focus on something new. Profit was created, contracts concluded. Commissions transferred to accounts. Mandatory use mode is set. There is no value in spending more money. We are done and we can start looking for a new diagnosis again. We may still advise governments to stop reimbursing for this drug, but to leave the obligation to use it. Why? To maintain the flow of money and while there is room in public budgets for the payment of a new miraculous treatment, which we will come up with next.
Jiri Urbanek, DVM, MBA having degrees in veterinary medicine and business, worked most of his career in managerial positions in pharmaceutical industry. Currently trains managers and sales teams both, and acts as a business consultant and teaches students of management MBA programs. He is the author of the book "I take no sh*t - Emotional Sales for a Better Life" (Czech Republic 2017 in Czech language) and co-author of the book The Power of Mental Wealth (USA 2020)
LinkedIn profile of author: http://linkedin.com/in/drjiriurbanek
https://blog.aktualne.cz/blogy/jan-hnizdil.php?itemid=40538
***
J.Š. 4.9.2021
Read more...