Aurélia Nguyen
Managing Director, Vaccines and Sustainability, Gavi, the Vaccine Alliance
Fundamental differences in developing vaccines and medicines mean that second generation vaccines are never going be as cheap as generic drugs, but there are still ways to reduce their cost.
Generic medicines – budget versions of brand-name drugs – are often quite literally a lifesaver because they are affordable. Vaccines are just as critical, protecting against infectious diseases such measles and polio, yet we don’t have cheap generics for vaccines.
This is because the biological nature of vaccines means the processes of manufacture, licensing and regulation are vastly different to medicines, leading to high fixed costs in development.
Since a vaccine can be the difference between life and death for billions of people, pushing for change in the factors that keep vaccine prices high is crucial.
Developing a vaccine never gets cheaper
So why can we have generic drugs but not vaccines? Manufacturers of generic drugs and medicines need to follow the same chemical recipe as the brand-name version, but they don’t necessarily need to test the generics on people to see whether they respond to them the same way.
A vaccine, however, is considered to be a new biological entity, and must be tested on people, which is costly and time-consuming. With vaccines, manufacturers may have to repeat trials for any innovation they want to make, adding to costs.
Along each step of production, hundreds of quality control steps are needed, raising costs and increasing timelines for production. All of this can send the cost of vaccine production soaring.
Since a vaccine can be the difference between life and death for billions of people, pushing for change in the factors that keep vaccine prices high is crucial.
Making vaccines more affordable for all
Since 2000, Gavi, the Vaccine Alliance, has been working to make vaccines accessible and affordable through innovative financing mechanisms such as committing to the purchase of a vaccine still in development, thereby reassuring the manufacturers that a market exists.
However, newer vaccines can be more complex – for example, pneumococcal conjugate vaccines, which protect against diseases like pneumonia – and this can make them more costly.
While funding programmes can lower the costs for poorer countries by subsidising the vaccines, ideally the cost to produce the vaccines would be lower in the first place.
How to drive vaccine costs down
Uncertainties about vaccine demand can mean manufacturers increase prices to ensure they get a return on their investment sooner rather than later. Introducing greater certainty of demand can therefore lower costs.
Investing in ways of improving biological standards and assays to speed up investigation or proof-of-concept could lower costs too, as could new platform technologies to accelerate R&D and better regulatory science for faster approvals.
These shifts along the value chain of vaccine production would ultimately help lead to cheaper vaccines for those who need them most.
