THE WASHINGTON POST | Pfizer CEO on the pressures of creating a covid-19 vaccine: ‘What is at stake is beyond imagination’

Albert Bourla is chief executive of the pharmaceutical company Pfizer. (Celeste Sloman/For The Washington Post)

Albert Bourla, 58, is chairman and chief executive of Pfizer, a multinational pharmaceutical company. Bourla is a doctor of veterinary medicine and began his career at Pfizer 27 years ago in his home country of Greece.

September 29, 2020 at 3:30 p.m. GMT+1
Reprinted for educational purposes and social benefit, not for profit. 

Albert Bourla, 58, is chairman and chief executive of Pfizer, a multinational pharmaceutical company. Bourla is a doctor of veterinary medicine and began his career at Pfizer 27 years ago in his home country of Greece.

The global pandemic hit just a year into your tenure as CEO at Pfizer. Can you talk about the pressure that you’ve felt, personally, to develop this vaccine?

The pressure is as high as you can imagine. It’s not an easy thing when you feel the hopes of billions of people and millions of businesses and hundreds of governments invested in this industry — and you are the leading company in this industry, and it happens that you are the CEO. And also a new CEO. You feel that pressure on your shoulders. And you feel that you need to rise to the occasion. I had moments that I needed a glass of wine — let me put it that way.

What is at stake is beyond imagination. It is the global economy because we’re paralyzed. It is the health of the whole planet in a pandemic that we haven’t seen in a hundred years. There’s a lot at stake. And then, to make it even worse, it has also been a political debate, which it shouldn’t [be]. And that also creates a unique situation. So you need to make sure that you navigate all that — and you still are able to deliver to the world what they hope you will deliver: a solution.

What are some of the exciting moments along the way, moments of hope?

Yes, multiple moments. The moment that I received a call, and they told me, “Check your email. I just sent you the first clinical data.” And [the data] were very good. So I was ecstatic. But, you need to know, in this endeavor, good news, usually they don’t last long. Maybe an hour. [Laughs.] But these moments of joy when you see that it’s happening, my God.

In order to develop a covid-19 vaccine in an unprecedentedly short — and, as some initially said, unrealistic — time frame, you instructed your researchers to think in different terms. Can you talk a little bit about that, and how you came to that thinking?

I came to it because I felt the pressure that we just discussed, right? I felt that, I don’t know, history has placed me in that role in a moment that we can have an impact. So I needed to play the role. Usually, we do things sequentially because otherwise it can become very risky, very expensive. So we don’t produce, don’t start the manufacturing process, don’t order equipment, don’t order supplies, before we know we have something. But if we do that, of course it will take a year from the approval until we can get the product manufactured. So I told them: “Don’t think like that. Think in parallel, not sequentially.” I told them: “This is not business as usual. Open the checkbook. Just do it.” They told me later they were shocked. [Laughs.] But in the next meeting everyone brought solutions.

I imagine that accelerated timeline changes the way you think, the way they think, about what is even possible.

Correct. And I think that would pose a question: If we did it with covid, why only covid? And why can’t we speed up treatments for cancer? Why can’t we speed up treatments for Alzheimer’s or Parkinson’s? So I think that is an experience that will teach us all a lot of things.

How did you think about the pricing or [return on investment] for this vaccine?

One is, how much you invest. And that was an open checkbook without even running any models of anything. Usually we price something based on the value it brings. But when at stake you have trillions of global economy, you couldn’t price it based on that. And also if you tried to do it based on demand, for a very long period of time the demand will always be higher than the offer. Because when suddenly 7 billion people want the vaccine, you can’t be able to manufacture it. So all of these basic principles, we had to throw them away.

And I came to what I felt, frankly, is the symbolic price. I saw what is the lowest vaccine range, which is the flu vaccine. It was around $20, and I said: Okay, let’s put it at 19 1/2 in the U.S. Basically, that’s it. It’s not any science. It is a philosophy. The government will give it for free, and I help by giving it to the government at a price at the lowest end. I’m not going to create an access problem.

Big Pharma is often vilified for the enormous profits it earns — lauded on the one hand for creating lifesaving medications and criticized, on the other, for reaping huge profits off of “human suffering.” Do you think that criticism of the industry as a whole is at all fair?

I think it’s completely unfair. But I think that also we made mistakes, and we played a role in bringing this. And I believe that in the U.S., particularly, the problem with patients being unable to pay their contributions is real. We have two distinct items here. One, it is how much medicines cost to the health-care system; the other is how much medicines cost to the individual who goes to the pharmacy to buy this medicine. The first one is around 12 percent of the total health-care cost — 12 percent. So by definition, we cannot be the big problem. Right?

But the bottom line is people in the U.S., predominantly, they trust their medicines. They don’t trust the ones who are making them. And that’s unfortunate. And we need to change it. Like I’ve said multiple times, reputation is lost in buckets, but you can earn it back in drops. I think covid-19 can become a catalyst because it is becoming very clear to society the value that this industry is bringing. But I don’t think that we are ready to declare any victory. We need to do a lot of things in the right way to make sure that we can restore, slowly, slowly, the reputation to what it needs to be, which is the best, the highest contributor of goods to humanity.

In September, Pfizer was one of nine drug companies that put out a letter pledging not to cut corners on safety — waiting until rigorous Phase 3 testing showed success to bring it to the FDA for approval. FDA scientists also came out with a public statement pledging the same. That’s a pretty unusual step to take. What was the discussion behind that? Why did that feel necessary?

Oh, it was very different than usual. But we felt that we had to do it because the discussions around if the medicines work or not are happening right now by politicians and journalists, instead of scientists, which are where they need to happen. And people are confused. Right now, they don’t know who to believe and what to believe. And we felt that, as this debate was peaking, we had to go out and say that we are going to stand with science. And we had to make it clear that if there are pressures, we are going to honor our legacy, and we are going to do whatever it takes to deliver a product that is safe and effective. And if we don’t reach that level, we will not even apply with the FDA.

Something like 35 percent of people have said they might not take this vaccine that everyone’s working so hard to develop. Obviously, people are wary because it’s a new drug, and long-term effects can’t be known at this point. There’s an anti-science sentiment right now, and with people hearing different things from different political segments, they are unsure, as you said, what to believe.

I do read these polls, and also I do speak to people, and I can see their concerns. I think the problem is there because [of] the political debate; it confuses people. So we need to educate people about how we do things. And everything we do needs to be transparent. I think the pledge helped.

The first priority is trying to figure out the vaccine. But then, would you see being involved in that education process or any kind of policy in rolling it out?

I would love to. But I think the most impactful [response] should come from independent scientists. People, they are confused. So it would be easy for someone, if they hear it from me, to feel that maybe I have a self-interest. But if they hear it from NIH, from Dr. [Anthony] Fauci, or other prominent scientists, I think it’s much more believable.

You’ve said that by the end of October, Pfizer will have a very good chance to know if the vaccine works or not, and you’re actually manufacturing the vaccine, even while it’s still undergoing trial, so that it could be ready as soon as it receives FDA approval.

Yes. This is the plan. Already in October, we have hundreds of thousands [of doses] ready. And I think we go to a few million in November, and many millions in December.

I’m sure that you are aware, even while you may try not to be, of the timeline of the upcoming election and pressure by the current administration to have a vaccine by then, with President Trump’s advisers calling a vaccine by the election “the holy grail.” You must think about potential ramifications of the timing of the release.

I understand how political and sensitive it is. The end of October is three days before the elections. A week later is four days after the elections. But I try to do the right thing. And that can be your only compass in situations like that. So I ignore. For me, the Election Day is an artificial day. The end of October is an artificial day. This is how we operate. If we can bring it earlier, we will. But it needs to be safe and effective. And we are not going to bring it before we are certain. The study will tell us. If the study tells us before the elections, so be it. If the study tells us after the elections, again so be it.

Of course, the FDA has been under pressure, politically, even called “deep state” for supposedly trying to slow things down. Do you have full confidence in its ability to override that pressure?

Yes. They are public servants that have proven their integrity over decades. And I’m sure they will do their part, particularly the staff. Right now, FDA is renowned in the world for their scientific expertise.

This experience has been a roller coaster for everybody — and certainly for you. What advice would you give people based on what you’ve learned?

The fundamental message for me was that if you are driven by purpose, if you know that the ultimate goal of success is to deliver on the promise that you give to society — and Pfizer’s purpose, it is “breakthroughs that change patients’ lives” — I can’t think of a breakthrough that can change more people’s lives than a vaccine for covid right now. That drove all my decisions. And, frankly, my investors, they applaud that. The same with my board. This is the Pfizer that they want, the Pfizer of science, the Pfizer that is liked by society. So the message with me is that when things are unprecedented and you are confused, your compass should be your purpose.

KK Ottesen is a regular contributor to the magazine. Follow her on Twitter: @kkOttesen. This interview has been edited and condensed.

2020-10-05T04:11:14+00:00September 29th, 2020|