Economic characteristics of Vaccines and Immunizations · 10 | Vaccines vs Pharmaceuticals argets...
Transcript of Economic characteristics of Vaccines and Immunizations · 10 | Vaccines vs Pharmaceuticals argets...
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Economic characteristics
of Vaccines and
Immunizations
Miloud Kaddar
WHO-IVB
www.who.int/immunization_financing
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Outline
Key questions that an economist working in
vaccinations ask her/himself ?
Economic features of vaccines and vaccinations
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VACCINE AND VACCINATIONS
a fabulous world for an economist...
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REDUCING VPD
INDUSTRY
HUMAN
RIGHTS COMMODITY
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Key questions: multidimensional
1) WHAT IS THE DISTRIBUTION OF
DISEASE BURDEN/VPD ?
2) WHAT ARE THE PRIORITIES ?
3) WHAT ARE THE MOST COST EFFECTIVE INTERVENTIONS ?
4) WHO PAYS: SOURCES AND MECHANISMS ?
DATA and
SITUATION ANALYSIS
PRIORITY SETTING
COST ANALYSIS
FINANCING
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ECONOMICS OF IMMUNIZATION AREAS OF WORK and CONCERNS
SUPPLY and DEMAND
OF VACCINES
PRODUCTS
Vaccinations
SERVICES
EFFICIENCY ACCESS
VIABILITY/SUSTAINABILITY
AVAILABILITY
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Evidence-Based Decision Making Process
1. Burden of 1. Burden of DiseaseDisease
What is the situation What is the situation
with mortality and with mortality and
morbidity of VPDs in morbidity of VPDs in
countriescountries?
2. Cost 2. Cost Effectiveness Effectiveness
AnalysisAnalysis
What are the strategies What are the strategies
that maximize that maximize
outcomes for every outcomes for every
dollar spentdollar spent
3. Supply and 3. Supply and ProcurementProcurement
Supply? Procurement? Supply? Procurement?
4. Planning 4. Planning and and
BudgetingBudgetingWho is going to Who is going to
pay? Options and pay? Options and
strategies for strategies for
financing? Financial financing? Financial
sustainability?sustainability?
Country Country ContextContext
1. Burden of 1. Burden of DiseaseDisease
What is the situation What is the situation
with mortality and with mortality and
morbidity of VPDs in morbidity of VPDs in
countriescountries?
2. Cost 2. Cost Effectiveness Effectiveness
AnalysisAnalysis
What are the strategies What are the strategies
that maximize that maximize
outcomes for every outcomes for every
dollar spentdollar spent
3. Supply and 3. Supply and ProcurementProcurement
Supply? Procurement? Supply? Procurement?
4. Planning 4. Planning and and
BudgetingBudgetingWho is going to Who is going to
pay? Options and pay? Options and
strategies for strategies for
financing? Financial financing? Financial
sustainability?sustainability?
Country Country ContextContext
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VACCINES AND VACCINATIONS ARE
DIFFERENT FROM OTHER
PRODUCTS AND SERVICES
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Vaccines vs Pharmaceuticals
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Vaccines Pharmaceuticals
- Focus mainly on prevention – not
patients but healthy subjects
- Key role for the government agencies
- Very low acceptance of side effects
Focus on treatment – patient is
generally suffering or sick
Key role for healthcare players
Acceptance of side effects varies by
severity of disease
High manufacturing and supply chain
complexity
(Cold Chain Management, complex
biological processes)
Medium manufacturing and supply
chain complexity
minimal generic competition and
limited price competition
Very few producers
Major sales through government
Number of products and generics
Increasing generic threat
Significant sales force and transaction
costs
Sales through physician as prescriber
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Vaccine: Economic characteristics…
Strategic product: part of national and global security
concern
Life saving product: one of most cost effective interventions
Induced demand and consumption: role of national and
international health agencies and of health professionals
Highly regulated (R&D, product, import , export and
distribution,..) : entry barriers.
Public Funding in most countries: Role of GoV and global
community in R&D and access
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Vaccine: Economic characteristics…(2)
Vaccine manufacturing is capital intensive
– Technology
– Expertise and know how
– High GMP standards
Vaccine manufacturing is a risky business
– Risk aversion: healthy and vulnerable people
– Biological products
– Clinical trials requirements
– Stringent regulation
Economy of scale, investment capacity and risk management are key
Few players both on supply and demand side
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Benefits of vaccines and vaccinations
Positive Externalities: Vaccination has positive effect
beyond individuals and provides indirect benefits to the
unvaccinated
Rationale for compulsory vaccination against infectious
diseases?
Most health economic evaluations of childhood vaccination
only capture the health and short term economic benefits
Measuring broader, long-term economic effects of
vaccination provide a more complete picture of the value
of vaccines.
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Immunization is an investment with a broad
economic impact
Immunization is a public health priority at national as well as at global level: MDGs, DoV/GVAP
Immunization is an international public good : multiple positive externalities. Collective benefit goes well beyond mortality and morbidity reduction.
Immunization is one of the most cost effective health interventions
Immunization should be seen as an investment
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www.who.int/immunization_financing
If you want to know more:
Immunization Financing Website
In partnership with the
Immunization Financing Website News
Featured Updates
The immunization financing website has been updated with information from new countries
New menus have been created on the website for immunization financing analyses and indicators
A new analysis of vaccine financing indicators in WHO member states for 2000-2006 is now available
The status of multi-year strategic planning for immunization in WHO member states for 2006 is posted on a new webpage
Other news, highlights and expected future updates of the site in 2008
New Country Pages Go to country pages
Ten new immunization financing country pages are available. At a glance, these country pages present a summary of the immunization financing situation and provide key data and indicators of interest. The information provided in these pages are based on the Financial Sustainability Plans (FSP). These pages are intended for country-focused analyses and offer the possibility to download existing Financial Sustainability Plan documents, accompanying annex materials, tools, and other relevant country specific information (ex: costing studies, financing assessments…). Pages are now available for the following 50 countries : County pages :: Afghanistan NEW :: Lao PDR :: Albania :: Lesotho :: Armenia :: Madagascar :: Azerbaijan :: Malawi :: Benin :: Mali :: Bhutan :: Mauritania :: Bosnia and Herzegovina :: Mozambique :: Burkina Faso :: Myanmar NEW
:: Burundi :: Nepal NEW :: Cambodia :: Niger NEW :: Cameroon NEW :: Republic of Moldova NEW
:: Comoros :: Rwanda :: Côte d'Ivoire :: Senegal :: DPR Korea :: Sierra Leone :: DR Congo :: Sri Lanka NEW :: Eritrea NEW :: Sudan NEW :: Ethiopia :: Tajikistan :: Gambia :: Uganda :: Georgia :: Ukraine :: Ghana :: United Republic of Tanzania :: Guinea :: Uzbekistan :: Guyana :: Viet Nam :: Haiti :: Yemen :: Kenya :: Zambia :: Kyrgyzstan :: Zimbabwe NEW
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Thank you !
Measles OPV
DTP
DT/TT/Td
Hep B
Yellow
Fever DTP-HepB
Hib Lyo
Hib Liq
Rubella JE PHK
Rotavirus
Varicella
MMR
Rabies
Influenza
IPV
Hep A
HPV
Cholera/
Typhoid
Live
DTaP +
combos
Cholera/
Typhoid
Killed
Pneumo
conj
BCG Influenza
Men conj
JE mouse
brain
Men PS
Miloud Kaddar
+41227911436