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V3P: Region Fact Sheet

This regional fact sheet is intended for use by MoH and vaccine procurement staff. The regional fact sheet provides information on all vaccines procured by AMR including analyses of:

• the presentations used in AMR compared to the rest of the world;

• the procurement methods used in AMR compared to the rest of the world;

• value to the market of the most frequently reported vaccines to the V3P from AMR and the rest of the world;

• prices paid by AMR, compared to rest of the world.

Increased knowledge about several aspects of vaccine market and purchasing may help to inform the development of policies related to market shaping and vaccine access.

The Vaccine Product Price & Procurement (V3P) initiative was launched to provide all countries with a platform for greater vaccine price & procurement transparency. The initiative collects data through the WHO and UNICEF Joint Reporting Form, and analyses and distributes information to relevant stakeholders to inform policy making and procurement processes. As of July 2017, the database contained data from 142 countries.

The fact sheet is exclusively based on the data reported through the JRF & V3P initiative, as of July 2017. Pool-procurement refers to vaccines procured through UNICEF SD and the PAHO Revolving Fund. Readers may access additional vaccine price and procurement information from reporting countries and procurement agencies (UNICEF and PAHO) on the V3P website (http://www.who.int/immunization/v3p) or by contacting v3p-project@who.int.

AMR

1AMR countries contributing to the V3P: Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Grenada, Guyana, Jamaica, Mexico, Nicaragua, Paraguay, Peru, Saint Lucia, Suriname, Trinidad and Tobago, United States of America, Uruguay.AMR countries not contributing to the V3P: Antigua and Barbuda, Bahamas, Barbados, Belize, Bolivia, Canada, Colombia, Dominica, El Salvador, Guatemala, Haiti, Honduras, Panama, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Venezuela.

HighlightsThe AMR1 region market is 15% of the global market in volume and 63% in value. The regional vaccine procurement habits are different from the rest of the world in several ways, which may serve to inform sustainable supply strategies:

• one vaccine type exclusive to the region;• considerably higher use of single- vs. multi-dose presentations than in

the rest of the world;• slightly lower use of pre-filled syringes than in the rest of the world;• a higher proportion of countries are pool-procuring;• HPV, Influenza (adult), Varicella, and Meningococcal vaccines have a

higher relative value than in the non-AMR market; • three vaccines analysed for price suggest that:

» WAPs in non-Gavi, non-PAHO MICs may be slightly higher in AMR than in the rest of the world.

Vaccine MarketFor the data in the V3P database, the size of the vaccine market in AMR is approximately 15% of the global market by volume, and about 63% by value. However, a majority of HICs from Western Europe do not report price data to the V3P, so the relative size of the global market is higher than reported.

The global top 10 vaccines by value are PCV, HPV, Rota, Influenza (seasonal - adult), Varicella, DTP-HepB-Hib, MenA,C,Y,W-135 conj, MenC, DTaP-HepB-Hib-IPV, and BCG, and these 10 account for about 71% of the value of the market in AMR. The relative value of each vaccine type, in each market, is shown in Chart 1 (see page 2).

Chart 1 also shows that the primary differences between the AMR and the non-AMR markets are the greater relative values of HPV, Influenza (adult), Varicella, and Meningococcal vaccines in the AMR market. The value of each vaccine is more evenly distributed in the AMR market. The pertussis combination vaccines, PCV, and BCG account for 52% of the non-AMR market compared to only 21% of the AMR market.

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AMR

Products and PresentationsAMR uses 35 vaccine types out of 57 reported by non-AMR countries. One vaccine type (DTaP-HepB-IPV) is exclusive to AMR.

AMR uses five out of seven of the presentations used in non-AMR countries (Uniject and an intranasal sprayer are reported from non-AMR but at a frequency of <1% - not shown). There is, however, a slightly lower prevalence

of prefilled syringes and ampoules in AMR than in non-AMR countries (16% versus 17%, and 3% versus 8%, respectively).

Chart 2 shows a considerably greater predominance of single-dose presentations in AMR compared to non-AMR countries (63% versus 47%), and a lower prevalence of 20-dose presentations (7%) than in non-AMR countries (17%).

Chart 1. The relative value of the global top 10 vaccines in the AMR and non-AMR markets.

AMR non-AMR

AMR non-AMR

Chart 2. Prevalence of presentation sizes in AMR and non-AMR countries.

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AMR

Procurement MethodAMR has a higher predominance of pool-procurement (68%), compared to non-AMR regions (52%) (see Chart 3). Self-procurement in AMR is about half as prevalent as in non-AMR countries (16% versus 34%). The higher proportion of pool-procurement in AMR is a consequence of the PAHO Revolving Fund which a majority of AMR countries use for vaccine procurement.

Vaccine PricesThere is very limited data for non-Gavi, non-PAHO MICs in AMR, but for three vaccines analysed, WAPs in AMR were 2 to 19% higher than for the same single-dose vaccines in the non-AMR market (see Chart 4).

Minimum, maximum, and median prices for vaccines procured in AMR are shown in Table 1 (see page 4).

Vaccine AvailabilityReported manufacturers from AMR and globally, for each vaccine type, are shown in Table 2 (see page 5).

Chart 4. WAPs for three select single-dose vaccines in self-procuring non-Gavi, non-PAHO MICs in AMR and non-AMR, in 20162.

2Vaccines were selected on the basis of sufficient data for analyses – data for single-dose presentations from at least two countries in both AMR and non-AMR.

Chart 3. Prevalence of procurement method in AMR and non-AMR countries.

AMR non-AMR

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Table 1. Proportion of countries self-procuring, minimum, median, and maximum prices, number of products, and number of manufacturers for each vaccine type reported from at least five AMR countries, in 2016.

Vaccine type (ranked by frequency of use)

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AMR AMR price (all procurement methods, all income

groups): lowest (presentation size) / highest (presentation size) / median N

diff

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AM

R

N m

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AM

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N m

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MMR 22 $0.60 (10-dose) / $40.00 (1-dose) / $2.37 5 3 5

IPV 6 $1.73 (5-dose) / $12.72 (1-dose) / $2.80 4 2 7

Influenza (seasonal – adult) 29 $1.97 (10-dose) / $25.07 (1-dose) / $4.30 8 6 11

BCG 20 $0.14 (20-dose) / $0.94 (10-dose) / $0.16 5 4 16

bOPV1,3 7 $0.12 (20-dose) / $0.25 (20-dose) / $0.13 4 3 10

YF 7 $1.05 (10-dose) / $35.46 (1-dose) / $1.20 3 2 4

DTP-HepB-Hib 8 $2.00 (1-dose) / $4.00 (1-dose) / $2.25 5 4 11

Td 31 $0.10 (10-dose) / $19.69 (1-dose) / $0.15 7 6 13

HepB (adult) 23 $0.19 (10-dose) / $28.55 (1-dose) / $0.42 9 5 10

DTP 15 $0.20 (10-dose) / $1.20 (10-dose) / $0.24 5 5 8

PCV 17 $3.30 (1-dose) / $120.39 (1-dose) / $15.33 4 2 2

HPV 42 $3.74 (1-dose) / $133.15 (1-dose) / $10.37 5 4 4

Varicella 27 $14.10 (1-dose) / $88.34 (1-dose) / $15.99 3 3 4

Rota 20 $2.50 (1-dose) / $86.75 (1-dose) / $6.50 2 2 3

DT 0 $0.08 (10-dose) / $0.98 (10-dose) / $0.13 4 4 11

Rabies 20 $6.30 (1-dose) / $16.13 (1-dose) / $11.98 3 3 7

Pneumo ps 33 $6.14 (1-dose) / $46.40 (1-dose) / $8.48 2 2 2

HepB (ped) 25 $0.20 (1-dose) / $12.30 (1-dose) / $0.35 5 3 13

Influenza (seasonal – ped) 25 $1.35 (20-dose) / $19.14 (1-dose) / $1.48 5 4 6

Hib 14 $1.95 (1-dose) / $12.48 (1-dose) / $2.05 3 3 4

DTaP 29 $10.85 (1-dose) / $16.85 (1-dose) / $12.27 4 2 3

HepA (ped) 50 $6.70 (1-dose) / $18.23 (1-dose) / $9.47 6 4 9

MR 20 $0.63 (10-dose) / $2.25 (1-dose) / $1.24 2 1 3

MenA,C,Y,W-135 conj 40 $20.30 (1-dose) / $89.16 (1-dose) / $48.13 3 3 4

AMR

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AMR

Table 2. Vaccine manufacturers reported by AMR countries, and additional manufacturers reported from other regions but not from AMR.

Vaccine type Manufacturers reported by AMR countries Additional manufacturers not reported by AMR

BCG FAP (Fundação Ataulpho de Paiva); InterVax; Japan BCG Laboratory; Serum Institute of India

AJ Vaccines A/S; BB-NCIPD; Biomed Lublin; China CNBG; GreenSignal Bio Pharma Limited; Institut Pasteur Iran; Institut Pasteur Tunis; IVAC (Institute of Vaccines and Medical Biologicals); Mikrogen; PT Bio Farma (Persero); Thai Red Cross Society; Torlak Institute of Virology, Vaccines and Sera

bOPV1,3 Bharat Biotech; Birmex; Serum Institute of India Boryung Biopharma; China CNBG; GSK; Haffkine Bio; PT Bio Farma (Persero); Razi Institute Iran; Sanofi Pasteur

DT BB-NCIPD; Biological E; InterVax; Serum Institute of India Arabio; China CNBG; Mikrogen; PT Bio Farma (Persero); Razi Institute Iran; Sanofi Pasteur; Torlak Institute of Virology, Vaccines and Sera

DTaP GSK; Sanofi Pasteur China CNBG

DTP Biological E; Boryung Biopharma; Butantan; PT Bio Farma (Persero); Serum Institute of India

IVAC (Institute of Vaccines and Medical Biologicals); Mikrogen; Torlak Institute of Virology, Vaccines and Sera

DTP-HepB-Hib Biological E; Centro de Ingeniería Genética y Biotecnología; Panacea Biotec; Serum Institute of India

Arabio; Bharat Biotech; GSK; Janssen; LG Life Sciences; PT Bio Farma (Persero); Shantha Biotechnics Private Limited

HepA (ped) Butantan; GSK; Merck Vaccines; Sanofi Pasteur Changchun Changsheng Life Sciences Ltd.; China CNBG; Institute of Medical Biology – Chinese Academy of Medical Sciences; Sinovac; Zhejiang Pukang

HepB (adult) Centro de Ingeniería Genética y Biotecnología; GSK; LG Life Sciences; Merck Vaccines; Serum Institute of India

Berna Biotech Korea; Institut Pasteur Iran; Janssen; Mikrogen; Shantha Biotechnics Private Limited

HepB (ped) GSK; Merck Vaccines; Serum Institute of India Biokangtai; China CNBG; Dalian Hissen; Janssen; LG Life Sciences; Mikrogen; NCPC GeneTech; PT Bio Farma (Persero); Sanofi Pasteur MSD; VABIOTECH

Hib Merck Vaccines; Sanofi Pasteur; Serum Institute of India GSK

HPV Butantan; GSK; Merck Vaccines; Sinergium None

Influenza (adult) Abbott Biologicals B.V.; Butantan; Green Cross Corporation; Sanofi Pasteur; Seqirus; Sinergium

GPO-MBP Co., Ltd.; GSK; Hualan Biological Bacterin Co., Ltd; Mikrogen; Npo Petrovaks

Influenza (ped) Green Cross Corporation; Sanofi Pasteur; Seqirus; Sinergium Mikrogen; Npo Petrovaks

IPV Bilthoven Biologicals; Sanofi Pasteur GSK; Institute of Medical Biology – Chinese Academy of Medical Sciences; PT Bio Farma (Persero); Serum Institute of India; Shantha Biotechnics Private Limited

MenACYW-135 conj GSK; Pfizer; Sanofi Pasteur Arabio

MMR Merck Vaccines; Sanofi Pasteur; Serum Institute of India China CNBG; GSK

MR Serum Institute of India Beijing Minhai Biotech; China CNBG

PCV GSK; Pfizer None

Pneumo ps Merck Vaccines; Sanofi Pasteur None

Rabies Bharat Biotech; Butantan; Sanofi Pasteur Chiron Behring Vaccines Private Ltd.; FSUE Chumakov; GSK; Novartis

Rotavirus GSK; Merck Vaccines Bharat Biotech

Td BB-NCIPD; Biological E; Butantan; InterVax; Sanofi Pasteur; Serum Institute of India

AJ Vaccines A/S; Boryung Biopharma; GSK; Mikrogen; PT Bio Farma (Persero); Razi Institute Iran; Torlak Institute of Virology, Vaccines and Sera

Varicella Green Cross Corporation; Merck Vaccines; Sinergium GSK

YF Bio-Manguinhos; Sanofi Pasteur FSUE Chumakov; Institut Pasteur Dakar

DISCLAIMER

Information contained in the V3P database is provided by participating countries and/or organizations procuring on behalf of countries that have agreed to share vaccine price and procurement data with V3P. Participating countries are solely responsible for the accuracy of the data provided.

The information contained in the V3P database does not in any way imply an endorsement, certification, warranty of fitness or recommendation by WHO of any company or product for any purpose, and does not imply preference over products of a similar nature that are not mentioned. WHO furthermore does not warrant that: (1) the information is complete and/or error free; and/or that (2) the products listed are of acceptable quality, have obtained regulatory approval in any country, or that their use is otherwise in accordance with the national laws and regulations of any country, including but not limited to patent laws. Inclusion of products in the database does not furthermore imply any approval by WHO of the products in question (which is the sole prerogative of national authorities). WHO will not accept any liability or responsibility whatsoever for any injury, death, loss, damage, or other prejudice of any kind that may arise as a result of, or in connection with the procurement, distribution and use of any product listed in the V3P database.