Hannah Kettler: "From Development to Delivery Globally: Case of Vaccines"
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PLEASE NOTE: THESE SLIDES MAY NOT DISPLAY PROPERLY ONLINE, BUT THEY ARE READABLE IF DOWNLOADED. October 28, 2018 This one-day conference explored the current pharmaceutical pricing landscape by bringing together leaders from the pharmaceutical industry, policymakers, legal practitioners, and scholars to engage in novel, interdisciplinary discussions to better understand current challenges and articulate best practices to address these issues. Participants assessed the current challenges presented in drug pricing policy, from development to delivery, in both the United States and international context. We also explored and articulated best practices to expand access to medicines and worked toward developing a plan for disseminating these practices more widely.
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Hannah Kettler: "From Development to Delivery Globally: Case of Vaccines"
- 1. Presenter Name 1 Presenter Name 2 Presenter Name 3 Month DD, YYYY October 24 2018 GAiA From Development to Delivery Globally: Case of Vaccines Hannah Kettler
- 2. Under-Five Child Deaths Worldwide 1960-2012 (in millions) © 2013 Bill & Melinda Gates Foundation | 2 PROGRESS IN GLOBAL HEALTH Source: UNICEF 5 10 15 20 1960 1965 1970 1980 1985 1990 1995 2000 20101975 2005 2012 6.6M 20M
- 3. © 2014 Bill & Melinda Gates Foundation | 3
- 4. 2015 © Bill & Melinda Gates Foundation | 4Source: BMGF vaccine investment analysis (amount paid and committed), 1998-2020 Program Areas Top Grantees Key: OUR INVESTMENT IN VACCINES BMGF has committed significant investments for vaccine policy, country systems, markets and product development to make life-saving vaccines available to developing countries and improve uptake
- 5. Supply Volume Guarantees Purchase Pre-payments Product Development Funding, including PDPs Early Stage Equity Stakes Technical Assistance Grants BMGF tools span upstream and incentives opportunities and include grants, contract management and program- related investments FOUNDATION INVESTMENT TOOLS Upstream Development Funding Tools (Product Development) Downstream Incentives Tools (Product Delivery) Grants Alternative Investments Key: Capacity Scale-up Loans Not Exhaustive Co-investment with other global health entities 2014 © Bill & Melinda Gates Foundation | 5 Working with Pooled Procurement Mechanisms Procurement
- 6. © 2013 Bill & Melinda Gates Foundation | 6 THE MENINGITIS VACCINE PROJECT Delivery-Focused Innovation A mid-1990s meningitis epidemic in Africa caused 25,000 deaths and left thousands more with permanent disabilities African leaders asked for help developing an effective, low-cost vaccine to stem the disease An innovative global partnership lead to development of the MenAfriVac® vaccine at US$.50/dose Introduction strategy included mass vaccination for immediate benefit and integration into routine childhood immunization programs
- 7. © 2013 Bill & Melinda Gates Foundation | 7 THE MENINGITIS VACCINE PROJECT Delivery-Focused Innovation An innovative, global partnership to end deadly Men A epidemics in Africa Rapid development and low cost – US$.50 a dose – were key A two-fold introduction strategy: • Mass vaccination to gain immediate benefits • Integration into routine childhood immunization programs Our Partners
- 8. © 2013 Bill & Melinda Gates Foundation | 8 MENAFRIVAC: AFRICAN MENINGITIS BELT Northern Sudan Southern Sudan Ethiopia Eritrea Kenya Tanzania Burundi Rwanda Uganda Central African Republic Congo Cameroon Nigeria Chad Niger Mali Mauritania Senegal Gambia Guinea Bissau Guinea Ivory Coast Burkina Faso Ghana Togo Benin 2010 ~20 million vaccinated 2011 ~35 million vaccinated 2012 ~48 million vaccinated
- 9. IMPACT OF GAVI ON CHILDHOOD IMMUNIZATION COVERAGE Source: WHO/UNICEF Estimates of National Immunization Coverage 9 Worldwide reported estimates of vaccine coverage 0 10 20 30 40 50 60 70 80 90 100 Bolivia was first to introduce rota with GAVI support in 2008 Hib HepB PCV Rota Nicaragua was first to introduce PCV with GAVI support in 2010 GAVI created the Hib Initiative in to help countries make informed decisions regarding the introduction of Hib GAVI started support for hepatitis B vaccines
- 10. © Bill & Melinda Gates Foundation | 10 LOW INCOME LOW PRIORITY
- 11. MAKING LOW INCOME HIGHER PRIORITY PCV vaccine introduction: high- and low-income markets Source: International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health. Vaccine Information Management System (VIMS) Global Vaccine Introduction Report, December 2015. Note: Limited projections are available for PCV introduction in high-income countries 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Percentageofcountriesthathave universallyintroducedvaccine Years since first introduction High-income markets Low-income markets ~4 years
- 12. Global introductions of new vaccines
- 13. Source: Latest available public CDC, WHO V3P, PAHO, UNICEF and open media data from Global Vaccine Market Model, March 2016. Note: Pricing shown is lowest price available in market. BRICs data is interpreted from WHO and media information and averaged because of wider variations in reported prices. CDC, PAHO and BRIC meningitis vaccines are various combination vaccines; Gavi’s is MenA only Gavi pays an average of 3% of USA prices for vaccines and approximately 25% of average BRICS pricing. Middle markets showed greater pricing pattern variance than high and low income markets $3.05 $4.50 $2.50 $0.64 $1.00 $0.16 $14.12 $5.00 $6.50 $26.00 $1.90 $0.20 $23.59 $48.59 $8.47 $30.00 $5.09 $3.20 $116.91 $107.97 $63.96 $84.56 $12.58 $11.08 $0.10 $1.00 $10.00 $100.00 Pneumo HPV Rotavirus Meningitis Polio IPV HepB Gavi PAHO BRICS USA GAVI VACCINE PRICING COMPARISON Illustrative only – base data is subject to change and interpretation. Not for quotation of forwarding. Not to be used for vaccine market dynamics analysis purposes More Recent Vaccines More Established Vaccines
- 14. PCV – 2015 Source: Global Vaccine Market Model, March 2016 $- $20.00 $40.00 $60.00 $80.00 $100.00 $120.00 1M 9M 17M 25M 33M 41M 49M 57M 65M 73M 81M 89M 97M 105M 113M 121M 129M 137M 145M 153M 161M 169M 177M 185M 193M 201M 209M 217M 225M 233M 2015AVERAGEPRICE SHARE OF WASTAGE-ADJUSTED DEMAND USA Other HICs UMICs LMICs Gavi
- 15. Rota – 2015 Source: Global Vaccine Market Model, March 2016 $- $10.00 $20.00 $30.00 $40.00 $50.00 $60.00 1M 5M 9M 13M 17M 21M 25M 29M 33M 37M 41M 45M 49M 53M 57M 61M 65M 69M 73M 77M 81M 85M 89M 93M 97M 101M 105M 109M 2015AVERAGEPRICE SHARE OF WASTAGE-ADJUSTED DEMAND USA Other HICs UMICs LMICs Gavi
- 16. 16 A SIGNIFICANT PORTION OF GH BURDEN LIES IN MIDDLE INCOME COUNTRIES 50 150 250 0 100 200 300 LIC MIC TotalHIC 158 93 2 252 2016 GH DALYs in Mio. 63% of GH DALYs in MIC Source: IHME for GH DALYs (G Finder definition), 2016 Sustainable financing – Market making - TB in MICs
- 17. © 2014 Bill & Melinda Gates Foundation | 17
- 18. © 2014 Bill & Melinda Gates Foundation | 18
- 19. THANK YOU
Editor's Notes
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- Image source: MenAfriVac_Slides_map_animation_simplified2.pptx
- © Bill & Melinda Gates Foundation
- Photo shows the Visitor Center of Bill & Melinda Gates Foundation in Seattle.