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Abstract/Summary
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INTRODUCTION:. One of the barriers to meeting Millennium Development Goal Number 4 is access for large populations of developing countries to vaccines against their most serious and common diseases. Innovative vaccines have been more readily available at affordable prices once more producers enter the market, but this means that there will be a delay in access until these manufacturers can access the technology. Several solutions to enhance access have been proposed; none so far is optimal.
METHODS: The factors relating to competition in the market and an affordable price were examined. Historical price data to countries were reviewed. Various explanations for lack of competition were also analyzed, including unequal access to financing, lack of optimal research and development capacity, barriers to technology transfer, issues in accessibility to intellectual property.
RESULTS: Differences in vaccine scale up, know-how, GMP practices and regulatory oversight are decreasing between emerging suppliers and established multinationals. Developing country vaccine prices are at about the same levels for all manufacturers, but the level of vaccine development is lower for emerging suppliers who have few high priced markets to offset investments. There appear to be three major differences between multinational manufacturers and emerging suppliers:
(1) limited access to research results that lead to new vaccine constructs;
(2) barriers to vaccine technology development relating to blocking intellectual property;
(3) inability to spread the investments that would be incurred in addressing issues (1) and (2) over a large enough financial base.
In terms of pricing, experience with early adopting countries has shown that other factors may overcome the perceived pricing barrier: that is, willingness to pay appears not to correlate with country wealth.
CONCLUSION: Based on these analyses it appears that the interventions of the international community might be better directed to achieve vaccine access.
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