Drug versus vaccine investment: a modelled comparison of economic incentives
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RESEARCH
Open Access
Drug versus vaccine investment: a modelled comparison of economic incentives Stéphane A Régnier1,2* and Jasper Huels2
Abstract Background: Investment by manufacturers in research and development of vaccines is relatively low compared with that of pharmaceuticals. If current evaluation technologies favour drugs over vaccines, then the vaccines market becomes relatively less attractive to manufacturers. Methods: We developed a mathematical model simulating the decision-making process of regulators and payers, in order to understand manufacturers’ economic incentives to invest in vaccines rather than curative treatments. We analysed the objectives and strategies of manufacturers and payers when considering investment in technologies to combat a disease that affects children, and the interactions between them. Results: The model confirmed that, for rare diseases, the economically justifiable prices of vaccines could be substantially lower than drug prices, and that, for diseases spread across multiple cohorts, the revenues derived from vaccinating one cohort per year (routine vaccination) could be substantially lower than those generated by treating sick individuals. Conclusions: Manufacturers may see higher incentives to invest in curative treatments rather than in routine vaccines. To encourage investment in vaccines, health authorities could potentially revise their incentive schemes by: (1) committing to vaccinate all susceptible cohorts in the first year (catch-up campaign); (2) choosing a long-term horizon for health technology evaluation; (3) committing higher budgets for vaccines than for treatments; and (4) taking into account all intangible values derived from vaccines. Keywords: Incentives, Vaccines, Drugs, Research and development, Investment, Net present value
Background It has been argued that the vaccines market is not attractive to manufacturers [1]. Even with the successful launches of vaccines against pneumococcal and human papilloma virus diseases and pandemic influenza, vaccines’ share of the global medicines market remains marginal at approximately 3% (2010 figures) [2,3]. Historically, manufacturers have preferred to invest in potential blockbusters and the number of manufacturers producing vaccines in the USA dropped from 37 to 10 between 1967 and 2002 [1,4,5]. Currently, four-fifths of the market is held by only five manufacturers [3]. As a consequence, investment in vaccines is relatively low, with manufacturers only spending $750 million on research and development (R&D) for vaccines in 2000 compared with $26.4 billion for * Correspondence: [email protected] 1 Université de Neuchâtel, Pierre-à-Mazel 7, Neuchâtel CH-2000, Switzerland 2 Novartis Vaccines & Diagnostics AG, Lichstrasse 35, 4056 Basel, Switzerland
pharmaceuticals [1,6]. One of the factors explaining the situation is low pricing, driven by the fact that not all of the intangible value may be taken into account when vaccines are evaluated [5-8]. We therefore developed a mathematical model to elucidate
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