Rising prices of mpox vaccine pose major obstacle in African order negotiations | World News

The Africa Centers for Disease Control and Prevention estimates the price of the Bayer vaccine at $100 per dose, while the World Health Organization puts it at $141 – more than most countries on the continent can afford, and many of them spend more on health care per capita than they need to cover amid a host of health problems including cholera, measles, malaria and HIV.

“Price matters,” said Helen Rees, chair of the WHO's Africa Advisory Committee on Immunization, adding that vaccine pricing makes them one of the “treatments that are too expensive to afford.”

The pricing model used by the global vaccine alliance Gavi has so far helped to lower the cost of vaccines by ensuring bulk supply, making them viable for manufacturers and ensuring the products get to where they are needed, but at this stage Bavaria's MPOX vaccine does not fit into that structure, she said.

“In a situation like this, there's limited supply and it's expensive to manufacture. This is not a cheap product to make,” Rees said. “It does cost money.”

In the Republic of Congo, more than 80% of deaths from the disease are children, and as this new type of MPOX spreads from the Republic of Congo, the number of infections is increasing in African countries such as Burundi and Gabon. WHO Director-General Tedros Ghebreyesus has called on countries with vaccine stockpiles to donate.

Compared with other vaccines commonly used in low- and middle-income countries, the Bayer vaccine (sold under the names Zynneos, Imvammune and Imvanex) is fairly expensive, said Andrew Hill, a senior research fellow at the University of Liverpool who studies medicines costs. “Vaccines for most infectious diseases typically cost between $1 and $3 per dose when administered as part of a mass vaccination programme to millions of people,” he said.

Cost too much?

Bavarian Nordic “cannot continue to charge such high prices in Africa” ​​and will have to offer a steep discount or give permission to generic companies to mass-produce the vaccine at close to cost, Hill said. “Otherwise Africa will not be able to afford to protect its populations as the new lineage Ib epidemic spreads,” he said.

Public Citizen, a nonprofit consumer advocacy group, wrote Bayer last month urging the company to provide “fair access” to the MPOX vaccine, saying it was concerned the pricing “may be taking advantage of the recent global health crisis to put profits over people.”

With few competitors for its vaccine in Africa, Bayer has the upper hand in setting the price of the vaccine. Emergent BioSolutions and KM Biologics are developing the MPOX vaccine, but Thomas Bowers, a healthcare equity analyst at Danske Bank, said there is a “big gap between the three vaccines” in Bayer's favor.

Emergent BioSolutions' ACAM2000, which received FDA approval for mpox in late August, probably won't be used in Africa because it's not recommended for people with weakened immune systems, Bowers said. Japan's LC16 vaccine, made by KM Biologics, will likely be part of Africa's vaccine programs, but it's unlikely to spark price competition, he said. Meanwhile, Moderna and BioNTech's mRNA vaccine candidate is still “quite a long way away” from reaching the market.

The challenge for Bayern Air is negotiating a price that countries can afford but is also commercially viable. “Pricing is definitely an issue,” Chief Executive Paul Chaplin acknowledged in an interview last month, saying the airline was “responsibly” considering the matter and “want to find the right balance.”

“At the end of the day, if we harm Bavarian Nordic economically in any way, it will be of no benefit to the global community because then nobody will have access to the vaccine,” Chaplin said.

Chief Financial Officer Henrik Euel told Danish national broadcaster Danish Television last week that the airline would take into account which countries were paying when negotiating prices with Unicef. A company spokesman said Bayern also had contracts with Unicef ​​during the last polio outbreak that allowed it to offer differentiated prices depending on which country was buying from.

“Big discount”

Danske Bank's Bowers expects African organizations to pay about $100 per dose for the vaccine, which he said is a “relatively large discount” compared with the net price of about $200 on the U.S. private market.

“Even if you can make it for $10 or $20 a dose, that's just the cost of production. But the owners of the vaccine have invested billions of crowns in developing it and getting it ready to be manufactured, and they're taking a lot of risk,” Bowers said. “And that's part of what's reflected in the price of the vaccine. So it makes sense they're not just giving it away as a gift.”

But $100 is double what the US government is paying in some cases, and Bowers said the US government gets a discount because it's sponsoring the entire project.

Bowers said African health organizations could potentially negotiate lower prices if they order in bulk and commit to a vaccine program for at least four or five years. A long-term contract would provide more security for Bavarian, which pays for the upkeep of its plant even when it's not producing vaccines, he said.

The vaccine has passed clinical trials as a two-dose vaccination, but it is unclear whether African countries will adopt a one-dose approach to halve the cost. Bayer's CEO said data from several studies shows that a single dose can be up to 80 percent effective and significantly reduce hospitalizations.

First Edition: September 9, 2024 | 07:34 AM teeth