As countries race to develop a coronavirus vaccine, the price tag is going to be huge — and Europe doesn’t have the deepest pockets.

It took the threat that U.S. President Donald Trump could be trying to lure CureVac, a German biotech firm, to the U.S. before the European Commission said it would lend the company €80 million to try to produce a successful coronavirus vaccine in Europe.

That’s just a drop in the bucket of what will be needed to get any one of the dozens of vaccine developers over the finish line. Each stage of vaccine development comes with a hefty price tag, and there are more than 70 candidates in development.

What’s it going to cost? “Oh, billions — billions and billions and billions,” said Duane Schulthess, managing director of consultancy Vital Transformation. “We’re talking about a prophylactic vaccine for the entire population of the planet.”

After a candidate vaccine is developed, it first has to go through animal testing before even beginning human trials to test safety, which is followed by larger-scale tests to prove effectiveness. The vaccine then needs to be approved by regulators and produced on a vast scale — potentially billions of doses.

The Coalition for Epidemic Preparedness Innovations (CEPI), a foundation that finances research, estimated it will take $2 billion to get a successful vaccine for the coronavirus — not including manufacturing costs. Bruegel, an economic think tank, wrote that “public budgets for these efforts need to be multiplied up several times over.”

The Commission is hosting a pledging conference May 4 to raise money for a vaccine as well as diagnostics and therapeutics for the entire world. It’s working with other vaccine funders including the Wellcome Trust and CEPI to raise $8 billion to put toward this goal.

When asked by POLITICO, the Commission declined to say whether it would itself finance more vaccine projects.

Work hard for the money

British vaccinologist Sarah Gilbert is leading an effort to develop a shot at the University of Oxford made from a chimpanzee virus, which will become the first to enter clinical trials in Europe. Funding has, at times, been a challenge, she said.

Early on, Gilbert’s team received £2.5 million from the U.K.’s national science funders, which helped get things in order for clinical trials: “But then we needed more.”

“It’s an unusual situation, trying to raise funding,” she said, noting that as soon as she writes a grant application, the project has advanced further. To get through the rest of the (more expensive parts of the) process, Gilbert’s team was this week given another £20 million after the team’s announcement that it would get to clinical trials; the U.K. government said it was also making £22.5 million available to a separate vaccine project at Imperial College in London.

Experts say that, overall, Europe does a good job of funding earlier research phases, which are often done by smaller biotech companies or research institutions. But things get more expensive as the vaccine moves along: Because of this, it’s common to see larger life science companies take over later in the development.

“Europe is great at basic science,” Schulthess said, referring to early-stage research. “But when it comes time for the rubber to hit the road, and you start needing hundreds of millions of dollars to start moving into late-stage clinical research, you can’t really raise those sort of dollars or euros in Europe.”

In 2019, 80 percent of Europe’s mature biotech companies were acquired by larger American firms.

Even for those vaccines that enter clinical trials, only 20-40 percent are successful, Bruegel wrote. That means many millions will go toward clinical trials that show a vaccine is not safe or effective.

Jeremy Farrar, the director of the Wellcome Trust, said the key here is that countries need to invest in multiple vaccines — all the way to manufacturing at-scale and at-risk — because there’s no guarantee which vaccines will work and where they’ll come from. “That’s not a usual way of working,” he said.

Often at the request of governments during health emergencies, pharma companies drop their daily work to search for a specific vaccine. They did this successfully for Ebola; but that’s not always the case — researchers didn’t get a vaccine against Zika or the (different) coronaviruses that caused SARS and MERS before the outbreaks died down and the public moved on. Companies have felt burned in the past.

MSD, which developed a vaccine against Ebola, said it wouldn’t continue developing vaccines against further strains, according to STAT.

Many companies have jumped in to find a vaccine against the new coronavirus, risking huge sums if it fails to get through safety and efficacy tests. Companies like Janssen, a subsidiary of Johnson & Johnson, are scaling up production to make millions of doses before they’ve been tested.

But even though the potential market would be huge and a company could score major reputational gain if it’s successful, Bruegel said companies are prone to under-invest. “These returns on a COVID-19 vaccine might not be sufficiently interesting for private drug companies, compared to the high cost and risk,” the think tank wrote.

Many civil society groups worry that if a big pharma company is the winner, it will sell its vaccine at high prices, putting it out of reach for developing countries.

Sixty-one health groups wrote to the European Commission last month demanding that any research using public money should include an affordability clause. “Given the public health urgency, we cannot allow a ‘business as usual’ approach in which market dynamics dictate price setting at the expense of rapid access,” the letter reads.

Most experts agree that if we want a vaccine, governments will have to invest big money — and also that it’s worth their while to do so. “The health, human and economic cost of COVID-19, which would be avoided if there was a vaccine, is difficult to appreciate,” Bruegel wrote.

Sarah Wheaton contributed reporting.

This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.

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