Last month, Moderna CEO Stéphane Bancel issued a letter to the company’s shareholders effusively touting its accomplishments throughout the COVID-19 pandemic. “As our first approved product,” he wrote of Moderna’s COVID vaccine, “it has impacted hundreds of millions of lives around the world. . . . We are harnessing the power of mRNA to create a new category of medicines and a company that maximizes its impact on human health.”

As the LA Times’ Michael Hiltzik pointed out, a few salient points were absent from Bancel’s lengthy exercise in corporate back-patting — notably the company’s plan to raise the price of its vaccine from $20.69 to as much as $130 per dose. Also missing, though likely not far from the top of Bancel’s mind, was the nearly $20 billion in vaccine-related profits projected late last year — a figure that will rise considerably if the planned price hike goes into effect. Pfizer, which also developed a vaccine using mRNA technology, is reportedly planning to do much the same and similarly reaped a windfall worth tens of billions from its vaccine in 2022.

If nothing else, drug companies may soon rediscover the deep-seated public antipathy they mostly elicited prior to the pandemic. COVID-19 represented an unprecedented PR coup for pharmaceutical giants like Pfizer and Moderna as tribunes of a widely hated industry, whose quickly developed vaccine technologies transformed them from corporate malefactors into chirpy meme fodder in the span of just a few months. Often missed was the role both played in maintaining patent monopolies that slowed down vaccine production. Similarly left out of the story was the extensive role played by the public sector in the development of major COVID vaccines. In the case of Moderna alone, this included not only over a billion in grants from the federal government that sheltered the company from risk but also the untold sums poured into federally funded research concerned with mRNA technology.

Large pharmaceutical companies, in other words, took none of the risks — financial or scientific — necessary to develop vaccines and, not content with their existing billions in profits, are now set to gouge the public even more. As Hiltzik has observed, the recent recommendations of public health officials for annual COVID boosters probably means that the likes of Pfizer and Moderna will be guaranteed a further windfall whose costs will be borne by the public. It’s similarly likely both will continue to funnel billions into stock buybacks that could otherwise be spent on new research.

You would be hard-pressed to find a better illustration of why it’s the height of insanity to leave something as essential as public health to the profit-guided dictates of the market. With even a modicum of sensible regulation and consumer protection in place, much of what pharmaceutical companies have been doing since 2020 would be illegal. Upon taking office, Joe Biden’s administration ignored a golden opportunity to reconfigure existing rules around intellectual property vis-à-vis vaccine patents — also, less surprising, leaving off the table bolder options like the World War II–style nationalization of vaccine production.

It is, however, not too late. If companies remain intent on raising the price of goods likely to remain vital to the protection of public health in the years to come, the federal government should at minimum compel them to open up their patents. A new regulatory framework could also be introduced to restrict profiteering on essential drugs and pharmaceutical products developed on the back of publicly funded research. Alternatively, Big Pharma can be left to its own devices to repeat the current pattern in perpetuity: against the interests of the public and collective health, and to the boundless glee of its unfathomably well-off shareholders.