The impact of vaccine procurement methods on public health in selected European countries

Abstract

Introduction: Across Europe, immunization programs have brought immense benefits to the prevention of infectious diseases. The vaccines used are procured through a variety of models such as tenders and Pricing & Reimbursement. However, to date, the impact of the procurement method on the performance and sustainability of vaccination programs and on public health has received little attention. Areas covered: Drawing on a review of the academic and policy literature, complemented by an interview program with stakeholders involved in the procurement of vaccines, the authors have documented the relationship between procurement method dynamics and the level of protection against vaccine-preventable diseases in Germany, Italy, Spain and Romania for, measles-containing vaccines, hexavalent and influenza vaccines. Expert opinion: Price-based tenders can contribute to vaccine supply issues, discourage the provision of value-added services supporting vaccination coverage and disincentives future R&D. Although it is observed that price-based tenders can intensify competition in the short term, there can be unintended consequences such as damage to long-term competition. As European countries are committed to strengthen their immunization programs, they should consider the implications of current vaccine procurement models on the vaccine ecosystem and on public health.

Immunization funding across 28 European countries

“…Factors such as the process for purchasing of vaccines and incentives for HCPs to vaccinate could be associated with the allocation of funding across countries. A study conducted by Wilsdon et al highlighted that purchasing of vaccines through price based tenders may lead to reduction in choice and value added services such as public awareness campaigns that are important for vaccine uptake [18]. In the UK, GPs receive payment based on achieving certain vaccination rate targets.…”

Investigating the procurement system for understanding seasonal influenza vaccine brand availability in Europe

“…Wilsdon et al studied the relationship between procurement method, market dynamics and public health in several European countries [32], and also found that tenders are associated with the availability of fewer different vaccines. Furthermore they describe the impact of procuring vaccines through tenders on vaccine price, supply sustainability, value-added services and incentivizing innovation, and suggest sustainable approaches to vaccine procurement.…”

Pricing vaccines and drugs in Europe: worth differentiating?

“…Activities may consist of specific trainings for healthcare professionals and awareness campaigns for patients, except where vaccinations are mandatory, which is hardly ever the case in European countries nowadays [12]. Final results are substantially affected by public perception of vaccines values [1], with single physicians playing an important role in influencing vaccine hesitant families [16].…”

“…Third, the unit prices of vaccines which do not achieve a high rate of coverage (e.g., 90%) could be lightly decreased (e.g., −5%) from the second year until the target is achieved, in order to provide incentives for companies to support actively health authorities. A 'stick and carrot' financial incentive would address the (questionable) comment that the present price-based tenders of European countries could have negative (though unintended) effects on the rates of coverage [1], discouraging the provision of (unspecified) value-added services by companies.…”

“…The COVID-19 pandemic has recently brought to the forefront the vital importance of vaccines, of which Europe is the world leader in both development and manufacturing [1]. Although vaccines are considered pharmaceuticals from a regulatory viewpoint, there are substantial differences between vaccines and other pharmaceutical products in terms of both health and economics.…”