Executive Summary: Key Findings
The key Asia Pacific markets have an estimated vaccine market size of USD 2.3 billion in 2008
(50% of which is Japan), and this is forecast to grow to USD 3.0 billion by 2010. Approximately
two thirds of this market consists primarily of prophylactic vaccines (mainly paediatric), which
have some form of reimbursement or subsidy from most Governments
Prevention programs are high on the agenda of all Governments, and neonatal vaccinations
programs are either in place, or will soon be in place for major preventive diseases like Hepatitis
B. This is expected to lead to a drop in incidence over the next 20 years. However, programs for
vaccines like pneumonia are not in place, and depend on patient awareness (which is low)
Markets like China, India and Japan are dominated by local players, while Hong Kong, Korea,
Taiwan and Thailand are dominated by MNCs. Public-private partnerships are the trend in Asia,
and is one of the factors for successful market penetration, especially in China and Japan.
China, India and Japan have numerous local R&D based players that have strong pipelines with
innovative vaccines, and these local production lines are expected to boost market supply of
vaccines significantly by 2012
Physician choice vaccines is primarily driven by Government policies and relationship with
Government/state, and this is a crucial factor to success. The public sector is the highest user of
vaccines – the private market is relatively low (<30% of value) with the exception of Korea
Pricing of vaccines purchased by the Government is very low at ~10% of the private market price
(e.g. ~ USD 3-9 per course of HBV prophylactic vaccines, while cost in the private market is
approximately USD 30-90 per course)
Vaccine Market Size
Overview of trends by market segment
Asia Pacific Vaccine Market Revenues (2007 - 2011)
14 0 0
Japan : US$ 1.1 bn.
12 0 0 2011
South Korea :
US$ 285.0 mn. Japan
Revenues (USD) mn
10 0 0
2007: 1.1 billion
China : US$ 643 mn. 2011: 1.5 billion
CAGR: 15% Taiwan : 44.4 mn 800
India : US$ 70 mn. CAGR: 10%
CAGR: 4 % Hong Kong : 15.0 mn 600
US$ 48.0 400
CAGR: 12 %
S out h C hi na T a i wa n H o ng I ndi a Tha i l a nd
K or e a K o ng
•Japan remains the largest vaccine market with revenues of ~USD 1.1 billion in 2007. China is the 2nd largest and fastest growing
market, and is expected to be worth between 1.4 to 1.7 billion USD by 2011, and could potentially be Asia’s largest market.
• India’s market revenue is difficult to estimate, as the bulk of local manufacturing is exported. Local prices are very low, and it is
estimated at US$70million in 2007.
• China and India are rapidly developing as vaccine production hubs in order to cope with the strong local demand and capitalize on
increasing market potential. Local players play a key role in these markets, producing vaccines at lower costs and creating stiff
competition for leading multinationals for key disease indications.
•South Korea also has a booming vaccines market comprising of a reimbursed market for major vaccines, and a strong private
market. Market growth has averaged 12 percent annually and there is a strong private market and population with sufficient
purchasing power for newer adult and therapeutic vaccines which show promise to grow over time.
• Thailand’s vaccine market is currently valued at approximately USD 48 million and is heavily subsidized by the government, with
Sanofi Pasteur and GSK being the major market participants.
• Approximately 90% of volume use in Asia is through public programs. However, in terms of value, it represents ~70% of the
Sources: China – Frost & Sullivan, India – IMS, South
Korea-Korea Medical Device Association, Japan-Ministry of
Health Labour and Welfare (MHLW), Taiwan – Import 4
statistics, Thailand – Frost & Sullivan., Frost & Sullivan
For further discussion
This cluster of countries mainly import vaccines,
but have some limited local production. Post 2009,
Import based market Korea, Thailand and Taiwan all plan to increase
HONG local production capacity to decrease reliance on
vs predominantly KONG imported products. Korea and Taiwan – key
local manufacturing, vaccines are all reimbursed. Strong private market
strong MNC for new vaccines with proven effects, e.g. HPV.
competition Thailand and Hong Kong have smaller local markets
– reluctance of patients to pay for vaccines
Protective market –
CHINA 98% dominated by local production.
Use of older, less innovative products.
Potential plans to make
foreign products more easily available
through simplification of regulations
China & India have >30 local manufacturers,
Strong local of which 5-6 are dominant market players
production and with >50% market share. High pipeline for
manufacturing capacity and R&D
Optimally specified Market need vs gaps Underspecified products
Size of bubble
products (Low gap) (High gap/unmet need) represents market
Sources: Secondary research, stakeholder
interviews, Frost & Sullivan team analysis 5
Market attractiveness & clusters identified (2007-2011)
• Governments in Asia have vaccines and prevention of diseases as priority areas
in the next 5 years • Relationships
PEST growth • Increasing spending power of middle class, and availability of private insurance with Government
Drivers • Slow increasing awareness of the necessary of vaccinations, specifically and policy makers
amongst urban areas is crucial to enable
• Strong local R&D to produce innovative vaccines, and increase local production strong market
• Limited change in countries that have had vaccination programs in place for reach to
more than 10 years (e.g. Korea and Taiwan) physicians in key
Regulatory • Increase in coverage of mandatory vaccines to expand to additional vaccine Asian countries
Changes & types (e.g. China – up to 12 vaccines on national list). Strong grounding of
neonatal vaccination programs in all countries. • Products need to
• Preference to public-private partnerships (China, Japan) be in line with
• More transparent regulations to enable foreign players international
Value (‘000) CAGR (‘07-08) Key Players guideline
Market & HBV 450 HBV
MSD •Subsequent to
Influenza 300 Influenza
Landscape* Berna Biotech
potential & growth
HPV China state will be dependant
0 200 400 600
0% 10% 20% 30%
Gap Value Proposition
• Combination vaccines • Ability to produce single dose or
• Compliance of multiple dose vaccines combination vaccines
(Gaps) & • Efficacy of current vaccines • 100% efficacy vaccines
Opportunities • Public awareness on need for • Short lead time on manufacturing
vaccination to enable easy supply & storage
*Numbers to be confirmed
Market Capacity & Competition
COUNTRY Current (2008) Future (2010 onwards)
• 33 local manufacturers (including 6 local state-
owned giants, and rest with <15 million revenues)
able to produce 49 kinds of vaccines.
• Low unmet market need
• High local production capability (>1 billion doses)
CHINA • Multinational players with public partnerships (e.g. • Continue to be Government
Sanofi Pasteur partnership with Shenzhen state regulated market (control number of
vaccines available, especially from
• National vaccine program covers 12 vaccines (USD
400 million allocated in funding)
• High local production capacity
• High local R&D
• 25 local manufacturers, produce high quality
vaccines for local and export markets (WHO) • Low patient awareness and
INDIA • Local Government funding for local manufacturers willingness to pay
• Local production meets 98% of market needs • Plan to regulate production of influenza
• Low penetration of multinational players vaccine to prevent oversupply
• Antiquated vaccination programs – low • R&D and production of pandemic vaccine is
Government support a national project – funded by Government
JAPAN • High number of liver cancer cases and mortality • Open to foreign players, but still primarily
• Influenza: Produced 25 million doses in 06/07, local dominated market
used 19 million
Market Capacity & Competition
COUNTRY Current (2008) Future (2010 onwards)
• Multinational player dominance (e.g. • No specific plan for vaccination of
Engerix is market leader for Hep B) HBV carriers (Korea – plan for
reimbursed booster dose to reduce
TAIWAN carrier rate of HBV)
• Low local manufacturing (only 1 major
local manufacturer in each country)
• Declining carrier market for Korea
KOREA • Reimbursed/subsidised neonatal
and Taiwan (impact of vaccination)
vaccination programs in place (most
• Hong Kong expanding influenza
successful in Korea, followed by Taiwan)
vaccination to children <12 years for
HONG KONG free (budget of 100 mio HKD)
• Korea: Private market with capacity to pay
for products that have high awareness and
unmet need (e.g. Gardasil success in • Local production for influenza in
THAILAND Korea through patient campaigns) Korea, Taiwan and Thailand
• Korea and Taiwan: Strong reimbursement • Potential influx of vaccines from
China (into Hong Kong)
Strategic overview: Influenza profile
How to compete Product Evaluation
• Data proving efficacy
• High patient awareness • Current profile seen as high potential for use
• Public-private partnerships – but will have high dependance on patient
• Reasonable cost (current at US$11 – 46 per dose – awareness, perceived need for use and cost
• Need to be able to quickly expand manufacturing • Following are seen as high potential
capacity to other lines
• Short, quick production time (from a policy
Risks maker perspective)
• Non-needle delivery
• Very low patient awareness and perceived need on
• Non-refrigeration storage
influenza vaccines – will take large scale patients
awareness programs/campaigns and years to see • Non egg-based
awareness growth (low penetration currently <3% of • Protection against seasonal strains
• Seasonal – interrupted demand, unable to predict use • Areas of improvement needed to make it a
(e.g. Korea had oversupply in ’07 with 15 million high potential use product:
doses) • Long protection per dose (as compared to
• Local manufacturing coming into play by 2009-2012 current annual dosing) of ~ 5 years
in countries that don’t already have them (Korea, • Multiple strain coverage
Taiwan, e.g. Thailand will be able to produce 2 million • Long shelf like (>9 months)
doses annual in 5 years) • Efficacy (>80%) – trial results show efficacy
• Strong local R&D & production in India and China only vs placebo
(future requirement estimated at 65 million units, 25
million expected to be met by Sanofi Pasteur-
Shenzhen JV plant. Capacity to produce 50 million
doses by 2025)
Necessary evolvement to fit market needs
2010 Stage 3
Product ready for
distribution, structure in
Stage 1 Technology: Product in place for POV, private
line with market market
policy in place (Post 2012 market is
expected to be too
Production planned crowded – need early
People: (based on market mover advantage)
Need to identify and assessment of
establish local epidemiology,
relationships with competition, uptake,
Government and policy policy)
VACCINE MARKETS IN ASIA HAVE WELL ESTABLISHED PLAYERS WHO HAVE PUT SOUND
INVESTMENTS AND RELATIONSHIPS IN PLACE. IT WILL TAKE MORE THAN A GOOD PRODUCT TO
PENETRATE THIS MARKET – REQUIRES LONG TERM COMMITMENT, PATIENT AWARENESS,
FUNDING AND PEOPLE ON THE GROUND TO WORK WITH LOCAL GOVERNMENTS TO ENSURE
UPTAKE AND ACCESS TO PRODUCTS
03• Asia Pacific Vaccines Market Overview
This section presents an overview of the current market
scenario for vaccines and key trends across all countries
Vaccines Market Outlook
Overview of trends by market segment
• The vaccines market can be segmented into 3 major areas, pediatric, adult and therapeutic vaccines. However definitions within
these categories differ by country. For example, in Japan all cancer related (e.g. Gardasil) and hepatitis vaccines are categorized as
therapeutic, even though their mode of action is primarily prophylactic.
•Pediatric vaccines are still the mainstay of the market in APAC and generally account for more than 60 percent of total market
revenues. The primary drivers of this has been the implementation of national level immunization programs that cover the
comprehensive range of pediatric vaccines until age 12. Across most countries these vaccinations are provided FOC or subsidized to
• The influenza and combination vaccines vaccines market shows the most strong growth potential over the short term, due
primarily heavy investments in influenza preparedness and increasing recommendations for annual flu vaccination driving up
• Therapeutic vaccines market is still in its infancy or non-existent in most countries. The use of therapeutic vaccines is expected to
be more of long term prospect and targeted primarily at the private market.
Asia Pacific Vaccines Market Breakdown by Key Segments (2007)
J a pa n
S out h Kor e a
T a i wa n bn.
Hong K ong
I ndi a
Tha i l a nd mn.
0% 10 % 20% 30% 40% 50% 60% 70% 80% 90% 10 0 %
Ped iat r ic V accines A d ult V acci nes T her ap eut ic V acci nes
Healthcare and Demographic Indicators
Particulars Japan South China Taiwan Hong Kong India Thailand
Population 127.4 48.1 1,321.8 22.9 6.9 1,131.3 65.6
Birth rate (per 1000) 8.4 4.5 12.1 9.0 10.2 22.3 13.7
Population growth rate 0.5% 2.4% 5.3% 0.3% 0.1% 1.6% 0.7%
Infant Mortality rate (per 1000) NA 4.5 19.0 6.5 5.8 34.6 18.0
Life expectancy (female) 85.5 80.9 73.3 80.7 85.4 65.3 70.2
Life expectancy (male) 78.5 73.9 69.6 74.7 79.3 67.2 75.0
Public Hospitals 1,656 158 15,616 *24 41 166,993 1,871
Private Hospitals 7,370 1,331 3,575 **55 12 13,203 475
Health Clinics (government) 97,442 3,445 122,023 ***344 90 30,000 9,765
Private Clinics 98,609 26,119 156,844 18,667 NA NA 14,953
Total Healthcare Expenditure (USD) bn 406.6 41.8 152.9 23.8 10.2 59.8 9.3
Public Healthcare Expenditure (USD) 327.0 48.4 12.0
bn 21.7 14.9 4.3 3.6
Private Healthcare Expenditure (USD) 79.6 104.5 47.8
bn 20.1 8.9 5.9 5.6
Per Capita Healthcare Expenditure 2,918.0 1,318.0 116.0 981.2 1,857 54.0 141.3
Japan, South Korea, Taiwan and Hong Kong have the highest per incomes among the countries surveyed. As developed market, these countries have
strong healthcare infrastructure and well established immunization guidelines and strong healthcare access. China, India and Thailand are more
populous countries, with less well established infrastructure. However, strong population and economic growth has been coupled with strong
investment in healthcare related expenditure, this coupled with growing privatization of healthcare services creates strong market potential in these
Legend: * Medical Centers, ** Regional Hospitals, *** District Hospitals
Source : Frost & Sullivan (Base Year : 2007)
Market Segmentation & Snapshot
TYPE A TYPE B Universal Coverage,
High Growth &Volume Potential for Penetration High Demand
China, India & Thailand Japan South Korea, Taiwan &
Large market size reflective of large
Market Size, Revenues Large market size due to mature market Moderately sized market that are reaching
population heterologously distributed
and Demand status. maturity and are increasingly competitive.
population with high birth rates.
Market growth is anticipated to remain
Market Growth over the Strong market growth anticipated Moderate growth <10% expected to between 10-12 percent annually, driven
next 5 years throughout the forecast period > 15 percent. sustain over the forecast period. primarily by adult and therapeutic market
Current vaccination guidelines recommend Pediatric vaccines account for 65%or more
Pediatric vaccine market represents > 70-80
the usage of out-dated vaccines. Market is of the market – combi-vaccines. However,
Vaccine Usage Trends percent of market volume. Low penetration
likely to see a shift to newer products if adult and therapeutic vaccines are begin to
of adult & therapeutic vaccines.
appropriate legislation is approved. penetrate the market.
Pricing controls are in place for key The pricing structure of key vaccines is
High price sensitivity with central
vaccinations within the national vaccination determined by pricing controls put into
Price Sensitivity government playing role in large quantity
schedule. Out-of-pocket vaccination costs place by the local universal healthcare
based tender purchases. are among the highest in Asia. system.
Key vaccinations in the national schedule Universal healthcare coverage subsidizes
Subsidization of key childhood vaccinations are fully subsidized However the number
Reimbursement Status or reimburses a larger range of
only. Adult vaccinations e.g. Influenza, Hep of disease indications covered under the
(Current) national schedule are less than vaccinations, including those in then
B may be subsidized for high risk groups.
international standards. national schedule.
Strong local production (except TH) for
International manufacturers still dominate
vaccines through private & gov. linked Market is dominated by local domestic
Competitive Landscape the market with strong local production
entities. Focus on high volume production producers. Foreign penetration is < 2%.
only in SK.
with low cost products.
Combination vaccines, Influenza, Hep B
Key Growth Segments Combination vaccines, Influenza HPV, Pneumococcal vaccines
Drivers & Restraints of Type A Markets
(China, India & Thailand)
The high population demographic within
the 0-6 years and < 12 years segment
drives a high volume demand for pediatric
Threat of pandemics (e.g
influenza) drive investment in
vaccine manufacturing self
Government initiatives encourage local
based production as well as research and
development to meet local needs
Private-public partnerships provide
source of funds for immunization
programs and initiatives
Lack of awareness of
Lack of comprehensive healthcare immunization creates low
infrastructure limits accessibility demand for vaccines
and reach of immunization especially for non-
Low purchasing power creates a
high price sensitivity which drives
down profit margins for vaccine
Drivers & Restraints of Type B Markets
Growing elderly population
creates a demand for annual
Combination vaccinations are not widely
available in the local market in spite of
the demand and projected growth in the
pediatric vaccines market. Increasing initiatives from the Ministry
of Health Labour and Welfare (MHLW)
to promote increased innovation in the
local vaccine production industry
through research and development
The current healthcare and reimbursement in Japan
is focused primarily treatment based medicine. And
Lack of alignment of local vaccination thus preventative treatments such as vaccinations
guidelines to international standards have not been very well received.
has created a lack of innovation in the
local vaccine production industry and
lack of penetration of new innovative
vaccines to the market.
Drivers & Restraints of Type C Markets
Universal healthcare coverage through social health
insurance scheme which provides subsidization and
reimbursement for basic scheduled vaccinations
High per capita expenditure on
healthcare and demand for private
healthcare services Strong consumer awareness
drives up demand for both
therapeutic and combination Government initiatives
vaccines focused on preventive
healthcare drive investment
in vaccination programs
Low public awareness hinders
growth of non-mandatory/
Highly competitive market due to
large number of market participants
Disease and Immunization Trends
Reported cases of key vaccine preventable diseases
Disease Indication Japan South Korea China Taiwan Hong Kong Thailand
Chicken Pox (Varicella) 264,915 20284 0 17,949 61861
Cholera 47 7 1,094,402 0 3 986
Hepatitis A 79,349 202 67 372
Hepatitis B 316 1,327,225 196 74 4088
HIV 225 7,803 1978 414 9300
HPV (cervical cancer) 638,390 4658
Influenza 62,067 0 1 17311
Japanese Encephalitis 899,339 7 4,660 37 2 44
Measles 194 114,002 7 88 3256
Meningococcus 519 4 1,288 21 2
Mumps 4,557 292,964 11 181 9246
Pertusis 200,345 14 2,829 41 31 27
Pneumococcus 1,504 14 2,829 139028
Rotavirus - 0 3,399 NA
Rubella 2 35 589,864 53 38 305
Shingella N/A 131 49,920 246 67 NA
Tetanus (neonatal) 509 131 371,598 0 4
Tetanus (total) 8 1,988 10 1 NA
Yellow Fever (Dengue) N/A 97 0 0 0 25361
Disease and Immunization Trends
Country specific trends
- China is also a potential hotspot for emerging infectious diseases
with high incidence rate of mumps, varicella, rotavirus infections - 08 : Measles was re-designated as
and shingella in 2008. a notifiable infectious disease.
2,648 cases between Jan-Mar 08
- Influenza remains a pandemic concern with China, increasing the alone
demand for vaccinations which are provided free to high risk
groups. - Strengthening of surveillance &
increased vaccination ( with MR
INDIA - Outbreak of pertusis in 2007, over
- India remains a hotspot for infectious 200 confirmed cases with a higher
diseases with current immunization lacking percentage (31%) of adults
the penetration and reach to achieve effective affected
elimination due to disparate healthcare access - Over 1,0 million influenza cases
of large proportion of the population. are reported annually through the
- Measles, hepatitis B, polio, and tuberculosis sentinel system however less than
are still areas for concern. 50% of the population over 65 are
in compliance with annual
-The threat of increased zooneses includihg vaccination under the Preventive
influenza, leptospirosis, rabies and anthrax Vaccination Law.
- In 2008 alone, outbreaks of anthrax have
occurred in 3 India states. HONG KONG TAIWAN
- Influenza outbreaks remain a key - Measles, mumps, varicella SOUTH KOREA
THAILAND area of concern with the latest occur in sporadic outbreaks - Outbreaks of measles,
influenza outbreak occurring in early in Taiwan in spite of strong mumps and varicella are on
- Influenza remains a key concern in the
February 2008 – forcing even school vaccination coverage. the increase.
Thailand market with approximately
closures. ‘Importation” of the disease
150,000 to 600,000 cases annually in - Overall, immunization
from neighboring China and
2007 - The annual Influenza Vaccination penetration is high but
Japan has also occurred.
Program was has successfully sporadic outbreaks have
-AIDS and HBV continue to be areas of
administered over 275,000 flu - Strong influenza occurred.
concern, while outbreaks of measles
vaccine doses to eligible, high risk surveillance and vaccinations
and mumps do occur.
target groups in year 2007 alone. has seen a decrease in
number of reported cases
- SARS which drew critical concern in
between 2007 and 2008.
year 2003, has no new reported
incidence so far, but it is still the
most threatening disease outbreak
Disease and Immunization Trends
Percentage of target population immunized against key diseases
Percentage of Target Population Immunized (%)
Japan’s immunization schedules and vaccine specifications differ from
WHO and international standards. Lack of innovation has hampered
innovative vaccine development. Lower coverage and the use of
Japan outdated vaccines have led to a higher incidence of outbreaks of
preventable diseases that would be expected in a developed country.
South Korea has a strong immunization program and coverage – with
immunizations with the NIP being subsidized by central and local
South Korea governments.
Immunization coverage in China high with national immunization
schedule being effectively administered through China’s Center for
China Disease Control (CDC) network.
MCV Taiwan has also achieved strong immunization coverage with all
HepB3 scheduled vaccinations being subsidized through the NHI and provided
through public hospitals and health centers.
Hong Kong has also achieved high immunization coverage. Vaccinations
BCG for key diseases in the national immunization schedule are provided
free-of-charge. A recent change in the recommended immunization
Hong Kong schedule in 2006 to utilize more combination vaccines has been well
Vaccination coverage in India has yet to achieve levels above 90
India percent. This is due to disparate healthcare access across states and
also the lack comprehensive reporting and monitoring systems which
hampers analysis of the effectiveness of the monitoring activities.
Thailand Thailand has achieved very high levels of immunization coverage through
extensive government funded immunization initiatives. The vaccine
market is been heavily dependent on government funding, with the
private market still in its infancy. The government introduced 30THB
50 60 70 80 90 100
universal healthcare scheme helped improve coverage from 76 percent to
96 percent since 2002. The Thai system has been so successful I t has
Percentage of the population immunized (%)
been recommended as role model for other low income countries.
by key antigens
Source : WHO (2006)
F&S note: Immunization coverage figures presented here are sourced from WHO and UNICEF. Coverage representation is at a national level, however,
reporting coverage may be incomplete due to lack of surveillance data. Immunization coverage is also mainly for pediatric vaccinations and does not cover 20
Reimbursement & Pricing Scenario
Indication Japan South Korea China Taiwan Hong Kong India Thailand
BCG Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed
(Varicella) Self Paid Subsidized Self Paid Reimbursed Self Paid Self Paid Self Paid
Diphtheria Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed VACCINES
Haem. Influ. Self Paid Subsidized Self Paid Self Paid Self Paid Self Paid Reimburs
Type B ed
Subsidized PEDIATRIC vaccines in the national immunization
for schedules are generally reimbursed (BCG, DPT,
Hepatitis A Self Paid Self Paid children Self Paid Self Paid Self Paid Self Paid MMR, HepB, OPV). Type C markets are generally
shifting to higher usage of combination vaccines
with the inclusion of these in national level
Subsidized immunization programs with reimbursement.
for Reimburs Meningococcal vaccinations are also increasingly
Hepatitis B Self Paid Subsidized children Reimbursed Self Paid Self Paid ed being reimbursed.
cancer) NA Self Paid Self Paid Self Paid Self Paid
Influenza (>65 yrs) Self Paid Self Paid Self Paid Self Paid Self Paid ed ADULT
Japanese only) only)
Encephalitis Reimbursed Subsidized Subsidized Subsidized Self Paid Self Paid Self Paid
Measles Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed
Most adult vaccinations are not reimbursed with
Meningococcal Self Paid Subsidized Subsidized Reimbursed Self Paid Self Paid Self Paid the exception of influenza vaccinations for the
elderly and high risk groups which are increasingly
Reimburs being reimbursed.
Mumps Self Paid Subsidized Subsidized Reimbursed Reimbursed Self Paid ed
Pertusis Reimbursed Subsidized Subsidized Reimbursed Reimbursed d ed
Pneumococcus Self Paid Self Paid Self Paid Self Paid Self Paid Self Paid Self Paid
Poliomyelitis Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed
Rabies Self Paid Self Paid Self Paid Self Paid Self Paid Self Paid Self Paid
Rotavirus NA NA NA NA NA NA NA Currently, all therapeutic vaccines are self paid,
although there have been moves by advocacy
Reimburs groups to promote inclusion into national; level
Rubella Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed immunization programs, the high cost per dose
Tetanus Reimburs remains the key barrier.
(neonatal) Reimbursed Subsidized Subsidized Reimbursed Reimbursed Subsidized ed
Self paid (out-of-pocket) vs reimbursement scenario
COUNTRY Reimbursement Scenario Out-of-Pocket / Self Paid
All scheduled vaccinations are fully reimbursed by the There are several vaccinations that are recommended but are
government, however, vaccinations have to obtained within the not mandatory under the national schedule that are self paid.
JAPAN scheduled time frame (of the national schedule) after which the These include annual influenza shots, chicken pox and hepatitis
cost of immunization will be self borne. B are among the most common self paid for vaccinations.
Though there is no public reimbursement system. However, the The majority of South Koreans opt for self paid private channels
central government subsidizes vaccine supply to the local for vaccinations (60 percent), as the access to public health
SOUTH KOREA governments who in turn subsidize the cost of providing the centers is not always convenient Recommended and other
vaccinations at a provincial level at public health centers. optional vaccinations are self paid and not reimbursed.
The CDC network provides vaccinations under the national Optional vaccinations that are recommended but not mandatory
immunization schedule free of charge through its extensive under the national immunization schedule as well as non-
CHINA network. recommended vaccinations are all borne as out-of –pocket
All vaccinations within the national immunization schedule are Vaccinations not with the national immunization schedule, or
fully reimbursed under the NHI. that are recommended as optional vaccination are borne as out-
TAIWAN of-pocket expenses.
The Childhood Immunization Program provides full Vaccinations against other diseases (optional, recommended or
immunization covers vaccinations for children up to the age of travelers vaccinations) could visit private institutions in which
HONG KONG 12. Free influenza vaccinations are provided to the public who the vaccinations will be charged at different rates.
meet certain requirements (high risk groups).
Basic pediatric vaccinations under the national immunization Vaccinations not in the national immunization schedule and
schedule are subsidized and provided FOC through public health recommended vaccinations are borne as out of pocket
INDIA clinics and vaccination camps. expenses. There is no centralized reimbursement system.
All of immunization vaccines in EPI are reimbursable as it is Non reimbursable vaccine which are self paid include vaccines
covered by 30 baht scheme by NSHO (National Security Health not listed in the EPI, vaccinations take at private clinics or
THAILAND Office). However these are provided by public sector only. hospitals as well as certain combined vaccines.
Source : Frost & Sullivan
Leading Approved Vaccines by Country
Vaccine Name / Type` Japan South Korea China Taiwan India
BCG Japan B.C.G Statens Serum Institute, SSI, SXIBP, LIBP, CIBP, Serum Institute
Japan B.C.G. SIBP, CCIBP, BIBP Adimmune Corp.
DT (Dipthera-Tetanus) Takeda SK Chemical Serum Institute
DTaP Takeda Boryung Biopharma, highly competitive Sanofi Pasteur
Korea Vaccine GSK
HepA Kaketsuken GSK Bernabiotec, Zhejing GSK
HepB MSD (Banyu) Bernabiotech Korea, Shenzhen Kangtai, GSK, Serum Institute,
Korea Vaccine Beijing Tiantan, SIBP GSK Wockhardt
HepA+HepB GSK GSK
Hib GSK GSK GSK,Wyeth
JE Takeda CIBP, Beijing Tiantan Adimmune Corp. Shantha Biotech
Influenza Korea Vaccine LIBP, Ealong, GSK, Adimmune Corp., GSK, GSK, Sanofi Pasteur
Sanofi, Novartis Novartis, Sanofi Pasteur
Polio Japan Polio Sanofi Pasteur Bio Med, Panacea Biotech
Meningoccocal GSK, Wyeth LIBP, Sanofi Sanofi Pasteur
Takeda (individual Beijing Tiantan, MSD,
MMR vaccines for each GSK GSK Serum Institute
Pnemococcal Wyeth Wyeth CIBP Wyeth
Typhoid GSK, Sanofi Adventis Boryung Biopharma SIBP,LIBP,CIBP Cadila Pharma, GSK, VHB
Lifesciences, Zydus Cadila
Varicella Handaibiken Bernabiotech Korea, GSK
Source : Frost & Sullivan
Leading MNC players
Asia Pacific Product
presence by country Range
Boostrix (DTP), Infanrix (DTP), Havrix
GSK 19 (HepA), Fluarix (Influenza), Priorix (MMR),
Avaxim (HepA), VaxiGrip (Influenza),
24 Fluzone (Influenza),
VAQTA (HepA), MMR-II (MMR), Pneumovax
Merck 9 (Pnemococcal), Gardasil (HPV)
BCG (tuberculosis), Prevnar
Wyeth 3 (meningococcal)
Epaxal (HepA), Hepavax (HepB), Inflexal
Bernabiotec 10 (Influenza), Gripvax (Influenza)
Recent Approvals and Trends
- GSK’s Rotarix was recently approved in South Korea (Mar-08) while Cervarix has been approved in Hong Kong, Taiwan and South Korea. Cervarix has
recently been submitted for approval in Japan.
- MSD has already pursued approval in Thailand, Taiwan, and South Korea for Gardasil, and is currently pursuing approval for use in older women
within the age bracket of 30-45 years.
-Sanofi Pasteur leads the market in influenza vaccines and has invested heavily in a USD 100 million production facility in China to produce 25 million
doses annually by 2012.
- Wyeth’s key product across all markets where it is approved is Prevnar. Prevnar has been recently submitted for pre-qualification status with WHO in
order to gain access to inclusion in mass immunization programs.
Source : Frost & Sullivan
Profile of Global Players
All global players have private-public partnerships or joint ventures in key markets like China and Japan
Merck & Co expects the sales of its
In terms of revenues, GSK With a 20% share in 2006, Sanofi vaccines in 2007 to be in the
Biologicals is the largest player Pasteur is the second largest range of $2.8-3.2 billion, up
in the global vaccines market. player in the global vaccines from a figure of $1.7 billion in
market. 2006 (an increase of 73% on
GSK Biologicals had around 23% 2005).
share in the global vaccines Sanofi Pasteur, together with its
market in 2006. European joint venture with Merck in 2005/2006 launched three
Merck & Co, Sanofi Pasteur vaccines: Gardasil for cervical
GSK Biologicals is set to become an MSD, is a leader in flu cancer/human papilloma virus,
increasingly important part of vaccines. RotaTeq for childhood
GSK's business and has been diarrhoea caused by rotavirus,
transformed from a tiny In 2006, Sanofi Pasteur accounted and Zostavax for shingles.
company with one product and for 8.9% of Sanofi-Aventis'
$3 million in revenues, into a sales. With around a 10-12% share, Merck
$2 billion behemoth is the fourth largest player in
Sanofi Pasteur is well-positioned for the global vaccines market
With six vaccines in late-stage growth, as it has a leadership
development , GSK's vaccines position in influenza, The joint venture with Sanofi-
business has doubled in meningitis and boosters, and is Pasteur in Europe (Sanofi-
growth over the past five years also strong in polio, Pertussis Pasteur MSD), has given Merck
and the company expects it to and Hib with at least two major a major strategic edge in
double again over the coming product launches anticipated in penetrating in the European
five years. these areas during 2007 market.
Profile of Regional Players
• As the largest vaccine market player in
terms of revenue in Japan, Takeda
Serum Institute of India Sinovac Biotech Pharmaceutical Company Limited is a
research-based global pharmaceutical
• Serum Institute of India was • Sinovac Biotech Ltd.specializes in
founded in 1966 the research, development, • Offering a range of vaccines that
commercialization, and sales of covers in immunization schedule such
• Serum Institute has established human vaccines for infectious as DPT vaccine, DT vaccine, Measles
itself as the world's largest producer illnesses such as Hepatitis A and Vaccine, Tetanus vaccine, Rubella,
of Measles and DTP group of Hepatitis B, influenza and “SARS”. Mumps, MR combine vaccine, Japanese
vaccines. It is estimated that 2 out Sinovac is one of the leading Encephalitis vaccine and Influenza HA
of 3 children immunized in 2004, emerging biotechnology companies vaccine.
with a vaccine, received one in China.
manufactured by Serum Institute.
Serum Institute’s range of products • Sinovac is the first and currently the
have been used in 145 countries only company in the world to have
across the globe. been granted permission to begin
clinical trials for a vaccine to prevent
• Serum Institute of India, world’s fifth SARS. • KAKETSUKEN is a Juridical
largest vaccine manufacturer Foundation which researches,
registered approximately $180 • Sinovac is developing inexpensive, develops, manufactures and
supplies biological products such as
million in revenues in 2005-06. At modern vaccines that target the
vaccines for humans and animals,
present, Serum is the number 1 emerging market and that can and blood plasma derivatives.
biotechnology company in India. In compete with older technology Based in Kumamoto, Japan, the
2006, the growth rate of Serum vaccines for large-scale government foundation has pursued the
Institute of India was around 40 and international health organization preventive medicine fields of
percent. vaccination programs. microbiology, immunology and
serology, towards the improvement
of health and hygiene, and is a
leading company in the fields of
human vaccines and animal
Market Players : Competitive Positioning
PowderMed Pharmaceutical Companies
Degree of Innovation with vaccines division
Serum Institute developing vaccines
Low PT. Bio Farma
Breadth of Current Applications
Alliance and Partnership Analysis
Company 1 Company 2 Time Deal Structure Objective
To form Sanofi Pasteur MSD,a jont venture European
Sanofi Pasteur Merck 1994 Merger company dedicated exclusively to vaccines
To gain access to novel vaccine adjuvants and
GSK Corixa Corporation Apr 2005 Acquisition antigens
GSK Wyeth Sep 2005 Acquisition To expand its ability to increase vaccines supplies
To gain access to the vaccines market
Novartis Chiron Oct 2005 Acquisition
Pfizer Powdermed Oct 2006 Acquisition Strategic opportunity to enter the vaccine market
GSK China Sinovac Biotech Aug 2007 Partnership To promote a flu vaccine in China
Merck Crucell Sep 2007 Partnership To gain access to vaccine production technologies
Serum MOU with an intent to commercialize Serum
Institute Akorn Oct 2007 Partnership Institute’s six vaccines in the US market
Merck Technologies Nov 2007 Partnership To jointly develop an experimental hepatitis B vaccine
Shenzhen To develop and manufacture flu vaccines to meet
Government ~1/3 of local needs. Potentially the largest vaccine
Sanofi Pasteur (China) Dec 2007 Joint venture manufacting plant in Asia
Influenza in Asia Pacific : Disease and Management Trends
- China as with most countries in Asia Pacific currently has a low
influenza vaccination rate of 1.5%. - Japan has reported close to 1.0
million influenza cases annually
-The potential demand for influenza vaccinations is close to 60 between 2006 and 2007.
million doses annually.
- Japan utilizes approximately 18.7
million doses of influenza vaccines
annually or 74.5 percent of local
INDIA - For 2007-08, approximately 20
- Influenza is not currently considered a major million doses are planned to be
health threat in India. However, recent required.
outbreaks of avian influenza in West Bengal
have raised the profile of the disease.
- The estimated potential demand from the SOUTH KOREA
market is 2.5 million doses annually, most of
which would be channeled through the private - South Korea has a well developed commercial
market. market for influenza vaccines with 15 million doses
being consumed annually.
- However, the disease is viewed as a seasonal trend
with lower awareness levels than neighboring
- The WHO reports that there are an - Taiwan has developed an increasing strong network for
estimated 150,000 to 600,000 - Influenza scares hit Hong Kong Influenza surveillance and monitoring post SARS.
influenza patients annually in hard this year with the death of 3
Thailand. children during the annual flu - This includes the developments of National Influenza
season. Center which monitors all related influenza cases and
-With the threat of potential disease surveillance.
pandemics, Thailand has invested in - Prompt government response
influenza manufacturing facilities with resulted in closure of affect schools - Taiwan has a target to achieve immunization of 30
the capacity to produce more than 2 during the outbreak and prompted percent of the population annually against influenza by
million doses annual within the next 5 testing of influenza pandemic 2011.
years. preparedness plans.
-However, current annual consumption
is low at approximately 30,000 doses
Overview of Influenza Management in Asia Pacific
Summary of Disease and Management Trends
COUNTRY Current and Future Disease Trends Current Management Initiatives
Influenza is viewed as a seasonal disease in Japan and National level surveillance is in place and national
JAPAN there is a relatively high demand for vaccinations from stockpiles are determined on an annual basis. Japan
the aging population – however the coverage of the utilizes 20 million doses annually.
population over 65 is less the 50 percent.
Influenza is viewed as seasonal respiratory disease in The government promotes seasonal influenza
SOUTH KOREA South Korea. Currently approximately, 30 percent of the vaccinations through public healthcare centers during flu
population (15 million doses) is vaccinated annually. season as do academic societies.
The incidence of Influenza (common) is considered low, Beijing is at the forefront of influenza management with
CHINA it is not the concern for public or government except the city government finances to get all its citizens get
when national events such as the Olympics are occuring. vaccinated last year (local brands free for the olds and
imported brand half price for children).
Influenza is a closely monitored disease in Taiwan, with Taiwan has a strong centralized surveillance network in
TAIWAN the annual number of confirmed cases being low for the National Influenza Center in collaboration with the
major strains. CDC and national level pandemic preparedness plans are
Hong Kong is subject to seasonal influenza scares when The Influenza Vaccination Program is run annually under
HONG KONG outbreaks occur due primarily to its densely population the Dpt of Health and provides free influenza
situation. Common influenza outbreaks are expected to vaccinations to high risk groups, elderly and pregnant
continue to occur on an annual basis. women coverage under social insurance programs.
Influenza is viewed as a seasonal respiratory disease, There are currently no major national level initiatives
INDIA and outbreaks generally occur post the rainy seasons aimed specifically at managing influenza, with
government responding to outbreaks on a case by case
According to WHO Thailand 2007 study, it estimated that Thailand has invested heavily in production facilities for
THAILAND 150,000 to 600,000 influenza patients in Thailand influenza vaccines (USD 331.7 million) with the capacity
annually from 2008 onward. to produce 2 million doses annually.
Source : Frost & Sullivan
Overview of Influenza Disease Management in Asia Pacific
Key Challenges in the Management of Influenza
• Awareness is one of the key challenges in the management of influenza.
Although the profile of the disease has been raised following pandemic scares
and recent avian influenza outbreaks, the majority of the population across all
countries surveyed do not consider influenza vaccinations an annual
• Government campaigns, promotional activities by manufacturers along with
news reports regarding influenza outbreaks have all contributed to increased
awareness of the disease across Asia Pacific. However, awareness of vaccinations
as a prophylactic measure remains low.
• Influenza vaccines are not reimbursed across all countries surveyed.
• Taiwan, Hong Kong, Japan, Thailand and South Korea provide subsidized /
PRICE / free influenza vaccinations for elderly (>65 yrs).
• The cost of the vaccination is seen as prohibitive, while the need for an annual
dose is viewed as a burden in countries such as South Korea.
• The requirement for annual dosing for influenza vaccines and the inability of
the product to provide effective protection against all strains are challenge to
ANNUAL gaining public acceptance and more wide spread administration of the vaccine.
• Furthermore, Hong Kong physicians feel that the release of the annual
guidelines from WHO is too slow for an adequate response prior to the flu
Overview of Influenza Management in Asia Pacific
Treatment & Diagnosis Guidelines
Included in the National
Influenza vaccinations in Japan are solely on voluntary basis with free
vaccinations being provided for the elderly (>65 years).
Influenza vaccinations in South Korea are solely on a voluntary basis
SOUTH KOREA YES
with free vaccinations being provided for the elderly (>65 years).
Influenza vaccinations in China are solely on a voluntary basis with
CHINA free vaccinations being provided for the elderly (>65 years). Some
cities such as Beijing provide extra subsidies for children.
Influenza vaccinations are provided free to the elderly above 65 years
Voluntary since 1988 which has reduced the hospital admission rate for this
demographic to 54%.
Influenza vaccinations are provided free to the elderly. The annual
HONG KONG YES
Voluntary influenza vaccination program also provides for high risk groups
covered under social insurance.
There are no current guidelines in place for the prescribing influenza
INDIA vaccinations, with most physicians referring to WHO and related
Influenza vaccinations are provided for the elderly (>65 yrs), however
THAILAND there are no specific guidelines in place. Physicians generally respond
to WHO and MOPH recommendations when available.
Source : Frost & Sullivan