Economic impact of thermostable vaccines

Abstract

Background While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. Methods Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. Costs measured included the costs of vaccines, logistics, and disease outcomes averted. Results Replacing a particular vaccine with a thermostable version yielded cost savings in many cases even when charging a price premium (two or three times the current vaccine price). For example, replacing the current pentavalent vaccine with a thermostable version without increasing the vaccine price saved from $366 to $10,945 per 100 members of the vaccine’s target population. Doubling the vaccine price still resulted in cost savings that ranged from $300 to $10,706, and tripling the vaccine price resulted in cost savings from $234 to $10,468. As another example, a thermostable rotavirus vaccine (RV) at its current (year) price saved between $131 and $1,065. Doubling and tripling the thermostable rotavirus price resulted in cost savings ranging from $102 to $936 and $73 to $808, respectively. Switching to thermostable formulations was highly cost-effective or cost-effective in most scenarios explored. Conclusion Medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use.

Health economic evaluation of current vaccination strategies and new vaccines against tuberculosis: a systematic review

“…The study reported that the addition of a prime-booster vaccine, applied at age 10, was more costsaving than a replacement vaccine applied only at birth, albeit with an assumed efficacy of 70%, as reflected in the net societal cost-saving results: USD 5.6 vs USD 3.6 million [32]. Similar findings were also reported by Knight et al, who demonstrated that a new TB vaccine targeting adolescents and adultswith 60% vaccine effectiveness and a 10year protection periodwould prevent more TB cases and yield lower ICER values than would a strategy targeting infants alone: 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) vs 0.89 (0.42-1.58) million TB cases prevented and USD 378 (USD 150-USD 881) vs USD 1,692 (USD 634-USD 4,603) per DALY averted, respectively [40]. It was also predicted that such investments in a better novel vaccine with an efficacy of 75% and a 10-year protection period would be profitable, with even higher values when considering productivity lost throughout the world setting [41].…”

“…An additional 10 studies were excluded due to partial evaluation; five evaluated only the cost and five described only the effectiveness of BCG vaccination. We further excluded one study that evaluated the effectiveness of BCG vaccine in chain distribution rather than explicitly considering the economic aspects [16], one study in which the input parameters for the economic evaluation of BCG vaccination program could not be retrieved [17], and one that did evaluate the costeffectiveness of BCG vaccination but that was rather a review than it was original research [18]. Details are provided in Figure 1.…”

Room Temperature Stable PspA-Based Nanovaccine Induces Protective Immunity

“…As it currently stands, all prequalified WHO vaccines require refrigeration ( 73 ). Nanovaccines may enable next-generation vaccines to be stored without the need for refrigeration (i.e., eliminating the cold chain), allowing for vaccines to be sent to remote locations in need for vaccination, resulting in reduced medical costs and productivity losses associated with disease ( 74 ). Previous work from our laboratories demonstrated that nanovaccines encapsulating PspA were able to retain protein structure and activity following release, and a nanovaccine encapsulating the Bacillus anthracis protective antigen (PA) released biologically and immunologically functional protein following storage at both room temperature and above after 4 months ( 28 , 37 ).…”

New Routes and Opportunities for Modular Construction of Particulate Vaccines: Stick, Click, and Glue

“…The need for thermostable vaccines is widely recognized. Failure of the cold-chain has often led to wasting of vaccines or administering despite loss of activity ( 93 ). Important advances have been made by optimizing the engineering and chemistry of vaccine formation.…”