Advance Market Commitments for Vaccines

 David Warsh, in his weekly Economic Principals (not a mis-spelling, it's often about economists, and newspapers) writes about Advance Market Commitments for vaccines, as we await the rollout of the various vaccines for Covid-19: A Victory for Vaccine Market Design (and a scoop for a well-designed newspaper as well)

"the mechanism known as advanced market commitment is of comparatively recent origin. It is the discovery, if that is the word, of University of Chicago economist Michael Kremer, in a series of papers he wrote while teaching at the Massachusetts Institute of Technology and Harvard University some twenty years ago, culminating in the publication, in 2004,  of Strong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases, with his wife, Rachel Glennerster, in 2004.

"The new mechanisms they advocated were similar to those that in the eighteenth century gave rise to the development of the naval chronometer, necessary to determining longitude at sea. Governmental “pull” methods could complement the inherently risky “push” of private research and development.  AMCs – legally binding commitments to buy specified quantities of as yet unavailable vaccines at specified prices – were the most promising of the lot for bringing into existence medicines that otherwise might not pay. 

...

"I asked Kremer last week if he had been involved in the Warp Speed journey, The answer was no.  He and co-authors had spoken to staff at the Council of Economic Advisors in the run-up to the creation of Operation Warp Speed. They had co-authored an op-ed article in the NYTimes in May. But they had not met with Slaoui. He seems to have imbibed the basic idea as long ago as 2013, when he organized a session on the industry’s stock of common knowledge for the Aspen Ideas festival

"Kremer was recognized with a Nobel Prize in economics, with two others, in 2018, for work on policy evaluation, including the work on vaccines. But I was struck when Wall Street Journal editorial-page columnist Daniel Henninger suggested last week that the scientists at the pharmaceutical companies who developed vaccines against Covid-19 were “the obvious recipient for 2021’s Nobel Peace Prize.”

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It would be exciting to see an economist win two Nobels, one of them in Peace. Michael Kremer would be a great choice...

In the meantime, here's the latest in Kremer's string of papers on AMC, this one a theoretical treatment:

Designing Advance Market Commitments for New Vaccines

Michael Kremer, Jonathan D. Levin & Christopher M. Snyder

NBER WORKING PAPER 28168 DOI 10.3386/w28168    December 2020

Abstract: Advance market commitments (AMCs) provide a mechanism to stimulate investment by suppliers of products to low-income countries. In an AMC, donors commit to a fund from which a specified subsidy is paid per unit purchased by low-income countries until the fund is exhausted, strengthening suppliers' incentives to invest in research, development, and capacity. Last decade saw the launch of a $1.5 billion pilot AMC to distribute pneumococcal vaccine to the developing world; in the current pandemic, variations on AMCs are being used to fund Covid-19 vaccines. 

"This paper undertakes the first formal analysis of AMCs. We construct a model in which an altruistic donor negotiates on behalf of a low-income country with a vaccine supplier after the supplier has sunk investments. We use this model to explain the logic of an AMC—as a solution to a hold-up problem—and to analyze alternative design features under various economic conditions (cost uncertainty, supplier competition). A key finding is that optimal AMC design differs markedly depending on where the product is in its development cycle."

From the introduction:

"Mechanisms such as patents and prizes that stimulate research and development (R&D) for products sold in high-income markets may fall short in low-income markets. Patents generate deadweight loss along with the monopoly rents intended to incentivize investment; furthermore, the monopoly rents may be limited in countries with mostly poor consumers, particularly if the country or aid agency acting on its behalf ignores these patents or uses bargaining power or public pressure to push down prices. Prizes may lead to the development of products that, while meeting the letter of the competition’s technical specifications, fail to meet consumers’ true needs.

"The difficulty in meeting the needs of poor countries is particularly apparent in the marketfor vaccines. Vaccines are a highly cost-effective tool to improve global public health.1 Yet the provision of vaccines in poor countries lags widespread use in rich countries and the development of vaccines targeting diseases of poor countries has been disappointingly slow.2 This situation has sparked a host of initiatives to catalyze vaccine markets in developing countries. Among the most prominent has been an Advance Market Commitment (AMC) piloted last decade for a pneumococcal vaccine."