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US public investment in development of mRNA covid-19 vaccines: retrospective cohort study - BMJ

Mary Wilson

Well-known member
Published 01 March 2023

doi: https://doi.org/10.1136/bmj-2022-073747

Hussain S Lalani 1 2, Sarosh Nagar 1 3, Ameet Sarpatwari 1 2, Rachel E Barenie 1 4, Jerry Avorn 1 2, Benjamin N Rome 1 2, Aaron S Kesselheim 1 2

Abstract

Objective To estimate US public investment in the development of mRNA covid-19 vaccines.

Design Retrospective cohort study.

Setting Publicly funded science from January 1985 to March 2022.

Data sources National Institutes of Health (NIH) Report Portfolio Online Reporting Tool Expenditures and Results (RePORTER) and other public databases. Government funded grants were scored as directly, indirectly, or not likely related to four key innovations underlying mRNA covid-19 vaccines—lipid nanoparticle, mRNA synthesis or modification, prefusion spike protein structure, and mRNA vaccine biotechnology—on the basis of principal investigator, project title, and abstract.

Main outcome measure Direct public investment in research and vaccine development, stratified by the rationale, government funding agency, and pre-pandemic (1985-2019) versus pandemic (1 January 2020 to 31 March 2022).

Results 34 NIH funded research grants that were directly related to mRNA covid-19 vaccines were identified. These grants combined with other identified US government grants and contracts totaled $31.9bn (£26.3bn; €29.7bn), of which $337m was invested pre-pandemic. Pre-pandemic, the NIH invested $116m (35%) in basic and translational science related to mRNA vaccine technology, and the Biomedical Advanced Research and Development Authority (BARDA) ($148m; 44%) and the Department of Defense ($72m; 21%) invested in vaccine development. After the pandemic started, $29.2bn (92%) of US public funds purchased vaccines, $2.2bn (7%) supported clinical trials, and $108m (<1%) supported manufacturing plus basic and translational science.

Conclusions The US government invested at least $31.9bn to develop, produce, and purchase mRNA covid-19 vaccines, including sizeable investments in the three decades before the pandemic through March 2022. These public investments translated into millions of lives saved and were crucial in developing the mRNA vaccine technology that also has the potential to tackle future pandemics and to treat diseases beyond covid-19. To maximize overall health impact, policy makers should ensure equitable global access to publicly funded health technologies.

https://www.bmj.com/content/380/bmj-2022-073747
 
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