If the coronavirus pandemic confirmed anything about Big Pharma, it was that the business model of the pharmaceutical industry is based on unrelenting and unapologetic profiteering. Corporations seek to leverage their access to research by public institutions, their connections with oversight agencies, and their influence on politics to assure that they can maximize their windfalls. It’s not a pretty picture. So it will come as no surprise that the pharmaceutical giants would prefer that their business practices not be examined or debated. In particular, they want to avoid sharp scrutiny from public health activists, consumer advocates, and campaigners for access to safe-and-affordable vaccines and medications.

This is the harsh and constant reality, no matter which party controls the White House and the Congress, no matter who runs the Centers for Disease Control and Prevention, no matter who is calling the shots at the World Health Organization.

Just last week, the drug giant Moderna was scrambling to explain away concerns about its plans to quadruple the price for its Covid-19 vaccine, from $26 per dose to $110–130 per dose. “I would think,” claimed Moderna CEO Stephane Bancel, “this type of pricing is consistent with the value.”

Seriously? Let’s look at the numbers.

It costs Moderna as little as $2.85 to produce a dose of the vaccine. So we’re talking about a price that would be roughly $127 above the production cost for each shot that goes into someone’s arm. Even by the standard measures of pharmaceutical-company excess, this is, as Senators Elizabeth Warren (D-Mass.) and Peter Welch (D-Vt.) suggest, an example of “unseemly profiteering.”

Does Moderna need the money? No. Over the past two years, the company has made more than $18 billion in profits from its vaccine. The company is literally awash in money—so much so that its CEO is now worth more than $6 billion, up from $4.3 billion in 2021. “This is what corporate greed looks like,” says former secretary of labor Robert Reich.

But shouldn’t Moderna be able to profit from a vaccine it created? Actually, as the office of Senator Bernie Sanders notes, the Moderna vaccine was “developed in partnership with scientists from the National Institutes of Health (NIH), a U.S. government agency that is funded by U.S. taxpayers. The federal government directly provided $1.7 billion to Moderna’s COVID-19 vaccine research and development, and guaranteed the company billions more in sales.”

Sanders, as the new chair of the Senate Committee on Health, Education, Labor and Pensions, is urging the company to reconsider the price hike.

The Vermont independent wrote in a letter to Bancel:

The huge increase in price that you have proposed will have a significantly negative impact on the budgets of Medicaid, Medicare and other government programs that will continue covering the vaccine without cost-sharing for patients. Your decision will cost taxpayers billions of dollars. Your outrageous price boost will also increase private health insurance premiums. Perhaps most significantly, the quadrupling of prices will make the vaccine unavailable for many millions of uninsured and underinsured Americans who will not be able to afford it. How many of these Americans will die from COVID-19 as a result of limited access to these lifesaving vaccines? While nobody can predict the exact figure, the number could well be in the thousands. In the midst of a deadly pandemic, restricting access to this much needed vaccine is unconscionable.

Sanders is using his platform to draw attention to profiteering and bad practices by a pharmaceutical company. He’s got prominent allies on Capitol Hill, such as newly elected Pennsylvania Democrat John Fetterman, who says, “I ran for Senate to stop this exact type of immoral price gouging.” And these critics of the pharmaceutical industry know they have a willing audience among the American people—almost 75 percent of whom say they do not trust drug companies to price their products fairly.

But getting an honest debate going about Big Pharma profiteering is not always easy because, of course, the industry would prefer to shut that discussion down.

This is something critics of the industry have said for a long time while highlighting the massive spending by corporate donors and political action committees who’ve won influence with Democrats and Republicans. But an important report from Lee Fang now confirms the extent to which Big Pharma insiders will go to have their way.

Fang has uncovered an effort to thwart the international campaign to get governments to lift intellectual property rules so that information about vaccine development could be shared, and Covid-19 vaccines, tests, and treatments could be quickly and inexpensively manufactured in the Global South. After reviewing documents requested from Twitter, which detailed efforts by pharmaceutical companies to have messages from activists downplayed, Fang wrote that “pharmaceutical giants engaged in a global lobbying blitz to ensure corporate dominance over the medical products that became central to combatting the pandemic. Ultimately, the campaign to share Covid vaccine recipes around the world failed.”

While Fang observed that it was not clear whether the social media giant responded to the pressure, there was little question that the lobbying blitz was an ambitious one. And the effort to prevent governments from supporting a waiver to the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights—which would have eased intellectual property restrictions so that Covid-19 vaccines and treatments could be more easily and rapidly manufactured in developing countries—has been largely successful. Indeed, a report published last fall by Politico and the Bureau of Investigative Journalism revealed that “Big Pharma used its vast lobbying and influencing efforts to try to kill a proposal that threatened the very tenets of the industry.” The report continued:

Top industry executives enjoyed direct access to senior officials within the EU, which was opposed to the proposal from the very start and encouraged potentially rogue member countries, including Italy and France, to fall into line. And the U.S., after a dramatic late intervention in favor of a waiver for vaccines, eight months after the proposal had been tabled, failed to follow through as the Biden administration came under pressure from industry and Congress, as reported by the Intercept.

Maaza Seyoum, Global South convener of the People’s Vaccine Alliance, expressed concern about allegations that suggest the pharmaceutical industry and government allies—particularly in Germany—“tried to silence legitimate criticism during a crisis.” Lori Wallach, the veteran fair trade campaigner, reviewed the latest reports and warned that Big Pharma lobbyists and corporations giants, through “their greedy monopoly control of medicines,” have caused needless deaths and pushed people around the world further into poverty.

“They will go to any length to increase their profits,” says Wallach, the director of the Rethink Trade program at the American Economic Liberties Project, of the pharmaceutical giants.

This determination to engage in profiteering is a subject worthy of discussion and debate, as is the broader question of drug pricing.

The People’s Vaccine Alliance has long argued for “a people’s vaccine, not a profit vaccine.” Now, as Moderna is positioning for a dramatic new price hike to as much as $130 a dose for a Covid vaccine that costs $2.85 to produce, we should pay attention as the group reminds us, “That’s a markup of more than 4,000% above cost—on a vaccine that was developed with huge public funding. It’s obscene.”