Publication: Vaccines and Drugs : Characteristics of Their Use to Meet Public Health Goals
Date
2005-03
ISSN
Published
2005-03
Author(s)
Milstien, Julie B.
Batson, Amie
Wertheimer, Albert I.
Abstract
The major characteristics of vaccines
and drugs are reviewed and contrasted in seven key areas:
research and development, the market, supply sources,
regulation, procurement, financing, and access. The
comparison helps to identify areas where access could be
enhanced. These conclusions are drawn: (1) While public
investment in R&D has been more frequent for vaccines
than for drugs, it has normally covered only a fraction of
R&D costs. Concerted action is needed to stimulate
development of innovative public health products, with
public-private partnerships being a way to stimulate work
towards a specific goal. (2) Drugs and vaccines face
different market conditions that affect the ability to
forecast demand. While for drugs, use depends on individual
willingness to pay; the vaccine market depends on government
willingness to pay, based on epidemiological justification
for use of a product. (3) The supply landscape differs for
drugs and vaccines, with fewer vaccine manufacturers. This
limits competition, compared to the case of generic drug
products. Strict control of the supply chain for vaccines
minimizes leakage, and makes differential pricing easier to
implement. (4) A joint approach to the regulatory process
for drugs and vaccines will have benefits, especially as
their regulation is normally controlled by a single agency
within a country. Risk-benefit assessments by the US FDA do
not consider global implications, creating a need for
capacity to do risk-benefit assessments in developing
countries. (5) Similar procurement principles could be
applied to the prequalification process for drugs and
vaccines. (6) Societies often undervalue prevention in
health care, which impacts vaccine prices and financing. (7)
Activities that enhance access to drugs will also enhance
vaccine access, although the relative importance of
different factors inhibiting access may differ. Both
differential pricing as well as compulsory licensing may be considered.
Citation
“Milstien, Julie B.; Batson, Amie; Wertheimer, Albert I.. 2005. Vaccines and Drugs : Characteristics of Their Use to Meet Public Health Goals. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/6edeb55a-0ba9-58bf-a221-03ae59ef4a16 License: CC BY 3.0 IGO.”