OBJECTIVES The Global Alliance for Vaccines and Immunization (GAVI)
anticipated that growing demand for new vaccines could sufficiently
impact the vaccines market to allow low-income countries (LICs) to
self-finance new vaccines. But the time required to lower vaccine prices
was underestimated and the amount that prices would decline
overestimated. To better understand how prices in the LIC vaccine market
can be impacted, the vaccine market was retrospectively examined. Design
GAVI archives and the published literature on the vaccine markets in
LICs were reviewed for the purpose of identifying GAVI's early
assumptions for the evolution of vaccine prices, and contrasting these
retrospectively with actual outcomes.
RESULTS The prices in Phases I and II of GAVI-supported vaccines failed
to decline to a desirable level within a projected 5-year timeframe.
GAVI-eligible countries were unable to sustain newly introduced vaccines
without prolonged donor support. Two key lessons can be applied to
future vaccine market-shaping strategies: (1) accurate demand
forecasting together with committed donor funding can increase supply to
the LIC vaccines market, but even greater strides can be made to
increase the certainty of purchase; and (2) the expected time to lower
prices took much longer than 5 years; market competition is inherently
linked to the development time for new vaccines-a minimum of 5-10 or
more years. Other factors that can lower vaccine prices include:
large-scale production or alternate financing mechanisms that can hasten
vaccine price maturation.
CONCLUSIONS The impacts of competition on vaccine prices in the LIC
new-vaccines market occurred after almost 10 years. The time for
research and development, acquisition of technological know-how and to
scale production must be accounted for to more accurately predict
significant declines on vaccine prices. Alternate financing mechanisms
and the use of purchase agreements should also be considered for
lowering prices when planning new vaccine introductions.
Gilchrist, S.A.N.; Nanni, A. Lessons learned in shaping vaccine markets in low-income countries: a review of the vaccine market segment supported by the GAVI Alliance. Health Policy and Planning (2013) 28 (8) 838-846. [DOI: 10.1093/heapol/czs123]
Lessons Learned in Shaping Vaccine Markets in Low-Income Countries: A Review of the Vaccine Market Segment Supported by the GAVI Alliance