Questions remain over COVID-19 vaccine costs, roll-out in Ontario

When a vaccine for the virus behind COVID-19 is approved in Canada, Ontario will be tasked with vaccinating more than a third of the country’s population — and some medical experts say “question marks” remain regarding the cost breakdown and roll-out plans.

The province’s ongoing planning work comes as two vaccine candidates pre-ordered by the federal government are now showing promise.

On Monday, Moderna announced its vaccine appears to be 94.5 per cent effective, according to preliminary data from the company’s ongoing study, while competitor Pfizer Inc. shared a similar update last week.

“We do have an entire team at the Ministry of Health that is working on the plan for distribution,” said Ontario Health Minister Christine Elliott on Monday.

Transportation, cold storage options, and other logistics will be part of that process. Ethicists will also be at the table, Elliott said, to make sure an eventual vaccine is distributed “fairly and equitably.”

“We will be ready to go as soon as the vaccine is available,” she said.

But despite the optimism, others say key questions remain unanswered, partly due to the complex and unprecedented nature of planning the large-scale roll-out of a brand new vaccine — which will be in high demand, and potentially short-supply, at least initially. 

Extra costs after initial purchase

“I would like to hear a little bit more detailed explanation of what the priority groups are going to be,” said Matthew Miller, an associate professor at the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University in Hamilton.

“I think we can understand that there’s still question marks about how much vaccine will be available over which time frame.”

WATCH | Moderna says its COVID-19 vaccine appears to be 94.5% effective:

Minister of Public Services and Procurement Anita Anand says the government is putting in place contracts to boost refrigeration capacity to store millions of vaccine doses. 9:11

Health care workers and vulnerable populations are likely candidates for the top of the list, Miller said, though that decision will also have to weigh local issues such as the level of health care services in different communities.

“Definitely the costs, I think, are a question mark right now,” he said. “Because in addition to the direct costs of each vaccine dose that’s required, of course, there’ll be costs associated with the way that these vaccines are actually administered.”

There’s a price tag for every step of the process, from purchasing to refrigeration to administration fees, noted Paul Grootendorst, an associate professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto who has researched the economics of the pharmaceutical industry.

Grootendorst also speculated that the price per dose the government is paying — which hasn’t been made public — could fluctuate, depending on the final study findings.

“Let’s suppose that the efficacy turns out to be like 70 per cent … well, how does the price vary?” he questioned.

‘We do have an entire team at the Ministry of Health that is working on the plan for distribution,’ said Ontario Health Minister Christine Elliott on Monday. (Frank Gunn/The Canadian Press)

Feds ‘cannot disclose’ agreement details

In a statement, a spokesperson for Public Services and Procurement Canada said it “cannot disclose details of specific agreements” in order to protect Canada’s negotiating position and commercially sensitive pricing information, as well as to respect confidentiality clauses in the vaccine agreements made to date.

While the federal government has so far allocated more than $1 billion to secure access to seven leading vaccine candidates, some experts estimate the end figure could be more than three times higher, assuming everyone needs two doses of a successful vaccine.

Canadians won’t be paying out of pocket to get vaccinated, but it’s not yet clear what portion of the costs Ontario or other provinces will be shouldering to vaccinate residents.

WATCH | Procurement minister says government is boosting refrigeration capacity for vaccines:

Minister of Public Services and Procurement Anita Anand says the government is putting in place contracts to boost refrigeration capacity to store 33.5 million vaccine doses. 1:16

“The real issue that’s happening in the background is how much of this will be covered by federal money versus how much of it will be covered by provincial money,” Miller said. 

“Almost certainly, both federal and provincial governments will pitch in a share. And I’m sure the major negotiations right now are just around what the percentage breakdown ends up being.”

CBC News asked both Public Services and Procurement Canada and Health Canada about the potential federal-provincial cost split but did not receive an answer by deadline.

A spokesperson for Ontario’s Ministry of Health also did not provide any specific details, but said the province is “working with the federal government and other provincial and territorial partners” to plan for the potential delivery of a vaccine.

Costs a ‘drop in the bucket’

Regardless of how the costs shake out, Grootendorst said it’s a small price to pay to bring the virus behind COVID-19 under control.

“If we’re talking about a billion dollars here, or a billion dollars there, that’s all rounding error when it comes to the overall cost of managing a pandemic,” Grootendorst said. 

WATCH | With promising vaccine news, residents urged to stay vigilant: 

Doug Manuel, epidemiologist at The Ottawa Hospital, says promising news about the effectiveness of Moderna’s COVID-19 vaccine is welcome, but doesn’t mean residents should let their guard down. 1:13

“It really is a lower order of magnitude, compared to the cost to the economy and to society, mental health, etcetera of having people’s lives sidetracked by this circulating virus.”

Miller agreed, saying the costs are likely just “a drop in the bucket” compared to the economic and societal toll.

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