V3P: Region Fact Sheet Highlights The 1 region market is 4% of the global market in volume and 5% 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: higher use of single- versus multi-dose presentations; higher proportion of mixed-procuring countries; PCV and HPV vaccines have a much higher relative value in the market; three vaccines analysed for price suggest that:»» WAPs in non-gav MICs may be lower in than in non-gavi, non- PAHO MICs in the rest of the world;»» non-gavi MICs in purchase in variable volumes compared to non- Gavi, non-paho MICs in the rest of the world. Vaccine Market For the data in the V3P database, the size of the vaccine market in is 4% of the non- market by volume, and about 5% 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 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 67% of the value of the market in. 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 and the non- markets are the greater relative values of PCV and HPV in the market. These two vaccines account for about 52% of the value of the top 10 vaccines in but only 31% in non-. The Meningococcal and Varicella markets are absent in. 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 including analyses of: the presentations used in compared to the rest of the world; the procurement methods used in compared to the rest of the world; value to the market of the most frequently reported vaccines to the V3P from and the rest of the world; prices paid by, 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. 1 countries contributing to the V3P: Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Lao People's Democratic Republic, Malaysia, Mongolia, New Zealand, Papua New Guinea, Philippines, Republic of Korea, Samoa, Tonga, Vanuatu, Vietnam. countries not contributing to the V3P: Australia, Japan, Kiribati, Marshall Islands, Micronesia, Nauru, Niue, Palau, Singapore, Solomon Islands, Tuvalu. WORKING DOCUMENT November 2017 1
Chart 1. The relative value of the global top 10 vaccines in the and non- markets. non- Products and Presentations uses 35 vaccine types out of 58 reported by non- countries. No vaccines are exclusive to. uses four out of seven of the same presentation types as non- countries (not shown are Uniject and an intranasal sprayer reported from non-, and a plastic tube reported from, all at a frequency of <1%). The prevalence of prefilled syringes is similar in both and non- countries (16% versus 17%). Chart 2 shows a greater predominance of single-dose presentations in compared to non- countries (57% versus 49%), and 10-dose and 20-dose presentations account for just 35% of all presentation sizes compared to 46% in non- countries. Chart 2. Prevalence of presentation sizes in and non- countries. non- WORKING DOCUMENT November 2017 2
Procurement Method is predominantly pool-procuring, but the proportion of self-procurement in is the same as in non- countries (31%). has a higher proportion of mixedprocurement than non- (25% versus 14%) (see Chart 3). Vaccine Prices There is very limited data for non-gavi MICs in, but for three vaccines analysed, WAPs in these countries in were 7 to 67% lower than for the same single-dose vaccines in non-gavi, non-paho MICs in the non- market (WAPs in are from one or two countries) (see Chart 4). Minimum, maximum, and median prices for vaccines procured in are shown in Table 1 (see page 4). Chart 3. Prevalence of procurement method in and non- countries. non- Chart 4. WAPs from pool- and self-procurement for three select single-dose vaccines in non-gavi MICs in and non-gavi, non-paho MICs in non-, in 2016 2. Vaccine Availability Reported manufacturers from and globally, for each vaccine type, are shown in Table 2 (see page 5). 2 Vaccines were selected on the basis of sufficient data for analyses data for single-dose presentations from at least two countries in both and non-. WORKING DOCUMENT November 2017 3
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 three countries, in 2016. Vaccine type (ranked by frequency of use) % of countries self-procuring in price (all procurement methods, all income groups): lowest (presentation size) / highest (presentation size) / median N different products in N manufacturers in N manufacturers reported globally BCG 50 $0.07 (10-dose) / $6.93 (10-dose) / $0.16 7 6 16 HepB (ped) 47 $0.17 (10-dose) / $6.96 (1-dose) / $0.47 11 9 13 IPV 42 $1.90 (5-dose) / $41.99 (1-dose) / $2.47 5 3 7 bopv1,3 27 $0.12 (20-dose) / $1.25 (20-dose) / $0.19 8 7 10 DTP-HepB-Hib 10 $0.80 (1-dose) / $2.35 (1-dose) / $2.25 5 5 11 MR 44 $0.61 (10-dose) / $6.06 (10-dose) / $0.85 3 3 3 MMR 63 $1.15 (5-dose) / $9.75 (1-dose) / $3.24 5 4 5 Td 25 $0.13 (10-dose) / $11.81 (1-dose) / $0.15 5 5 13 TT 43 $0.05 (20-dose) / $6.37 (1-dose) / $0.13 6 6 14 HPV 83 $9.94 (1-dose) / $98.50 (1-dose) / $31.50 4 2 4 JE 100 $0.49 (10-dose) / $27.15 (1-dose) / $5.58 4 4 5 PCV 60 $3.30 (1-dose) / $100.94 (1-dose) / $16.21 3 2 2 HepB (adult) 80 $0.17 (10-dose) / $29.24 (1-dose) / $2.99 6 4 10 HepA (ped) 100 $2.93 (1-dose) / $22.28 (1-dose) / $2.93 6 6 9 Influenza (seasonal adult) 67 $1.50 (1-dose) / $7.41 (10-dose) / $6.84 6 5 11 Pneumo ps 100 $17.31 (1-dose) / $24.55 (1-dose) / $19.52 2 2 2 Hib 100 $4.85 (1-dose) / $9.12 (1-dose) / $6.57 2 2 4 DTaP-IPV 100 $10.32 (1-dose) / $27.85 (1-dose) / $19.64 2 2 2 WORKING DOCUMENT November 2017 4
Table 2. Vaccine manufacturers reported by countries, and additional manufacturers reported from other regions but not from. Vaccine type Manufacturers reported by countries Additional manufacturers not reported by BCG bopv1,3 AJ Vaccines A/S; China CNBG; InterVax; IVAC (Institute of Vaccines and Medical Biologicals); Japan BCG Laboratory; Serum Institute of India Bharat Biotech; Boryung Biopharma; China CNBG; GSK; PT Bio Farma (Persero); Sanofi Pasteur; Serum Institute of India DTaP-IPV GSK; Sanofi Pasteur None DTP-HepB-Hib HepA (ped) HepB (adult) HepB (ped) Biological E; Janssen; PT Bio Farma (Persero); Serum Institute of India; Shantha Biotechnics Private Limited Changchun Changsheng Life Sciences Ltd.; China CNBG; Institute of Medical Biology Chinese Academy of Medical Sciences; GSK; Sinovac; Zhejiang Pukang Centro de Ingeniería Genética y Biotecnología; Janssen; LG Life Sciences; Merck Vaccines Biokangtai; China CNBG; Dalian Hissen; Janssen; LG Life Sciences; Merck Vaccines; NCPC GeneTech; Serum Institute of India; VABIOTECH BB-NCIPD; Biomed Lublin; FAP (Fundação Ataulpho de Paiva); GreenSignal Bio Pharma Limited; Institut Pasteur Iran; Institut Pasteur Tunis; Mikrogen; PT Bio Farma (Persero); Thai Red Cross Society; Torlak Institute of Virology, Vaccines and Sera Birmex; Haffkine Bio; Razi Institute Iran Arabio; Bharat Biotech; Centro de Ingeniería Genética y Biotecnología; GSK; LG Life Sciences; Panacea Biotec Butantan; Merck Vaccines; Sanofi Pasteur Berna Biotech Korea; GSK; Institut Pasteur Iran; Mikrogen; Serum Institute of India; Shantha Biotechnics Private Limited GSK; Mikrogen; PT Bio Farma (Persero); Sanofi Pasteur MSD Hib GSK; Sanofi Pasteur Merck Vaccines; Serum Institute of India HPV GSK; Merck Vaccines Butantan; Sinergium Influenza (adult) IPV JE Abbott Biologicals B.V.; Green Cross Corporation; GSK; Sanofi Pasteur; Seqirus Bilthoven Biologicals; Institute of Medical Biology Chinese Academy of Medical Sciences; Sanofi Pasteur Chengdu Institute of Biological Products Co., Ltd; China CNBG; Sanofi Pasteur; VABIOTECH Butantan; GPO-MBP Co., Ltd.; Hualan Biological Bacterin Co., Ltd; Mikrogen; Npo Petrovaks; Sinergium GSK; PT Bio Farma (Persero); Serum Institute of India; Shantha Biotechnics Private Limited GPO-MBP Co., Ltd. MMR China CNBG; GSK; Merck Vaccines; Serum Institute of India Sanofi Pasteur MR Beijing Minhai Biotech; China CNBG; Serum Institute of India None PCV GSK; Pfizer None Pneumo Ps Merck Vaccines; Sanofi Pasteur None Td TT AJ Vaccines A/S; BB-NCIPD; Boryung Biopharma; InterVax; Serum Institute of India InterVax; IVAC (Institute of Vaccines and Medical Biologicals); PT Bio Farma (Persero); Serum Institute of India; Shantha Biotechnics Private Limited; Sanofi Pasteur Biological E; Butantan; GSK; PT Bio Farma (Persero); Mikrogen; Razi Institute Iran; Sanofi Pasteur; Torlak Institute of Virology, Vaccines and Sera BB-NCIPD; Bharat Biotech; Biological E; Boryung Biopharma; GSK; Finlay; Mikrogen; Torlak Institute of Virology, Vaccines and Sera 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. WORKING DOCUMENT November 2017 5