November 17, 2016
In a study published online in Vaccine, researchers from Rowan University School of Osteopathic Medicine, Princeton University, Yale School of Medicine and the University of Victoria have concluded that the cost of manufacturing and supplying human papillomavirus (HPV) vaccines to developing countries is much lower than companies currently charge. Using the best available evidence to support their findings, the study’s authors found that after the first set of vaccines are manufactured for affluent markets, the cost of producing more vaccines for developing countries should drop dramatically. Currently, two companies – Merck (Gardasil) and GlaxoSmithKline (Cervarix) – manufacture the vaccines which protect against HPV infection, the leading cause of cervical cancer, the second most common cancer among women worldwide.
“After manufacturing a first set of 15.4 million doses of Gardasil-4 to sell in affluent markets each year, the second set for developing countries costs between 48 and 59 cents a dose, a fraction of the Merck’s stated cost of $4.50 per dose,” said Donald Light, PhD, a professor of comparative health policy at Rowan University School of Osteopathic Medicine and the study’s corresponding author. “The amount of Cervarix produced is much lower, so costs are higher, but if produced at the same volume as Gardasil, the cost per dose of Cervarix would be about the same.”
In their study, the researchers noted that approximately 85 percent of the more than 500,000 new cases of cervical cancer and more than 90 percent of the deaths caused by the disease each year occur in lower- and middle-income countries. Both Merck and GlaxoSmithKline currently rank high in the global Access to Medicines Index and provide discount and charitable programs that increase access to HPV vaccines for some countries. The researchers wrote, however, that setting lower vaccine prices, “…is an important moral commitment by the companies to reduce global health inequities by preventing cancer and deaths in lower income countries.”
Because the researchers lacked access to verifiable manufacturing information from the companies, their analysis relies on published and commercial literature for information about the manufacturing of vaccines and on interviews with experts in the field. In doing so, the study authors based their conclusions on an examination of the estimated annualized capital costs, vaccine yield, the quantities and costs of raw materials, the personnel needed to manufacture the vaccines, factory and administrative overhead and the cost of filling and packaging of vaccines.
The article has major implications for Gavi, the Vaccine Alliance, that negotiates lower prices for vaccines for the world’s poorest countries. The authors believe that Gavi should reevaluate the price of HPV vaccines in light of this article, as price reduction would “greatly increase Gavi’s capacity to vaccinate more children.”
The research was initiated and partly funded by Doctors Without Borders, with the Rowan University School of Osteopathic Medicine making a substantial contribution. Staff from Doctors Without Borders commented on drafts of the final report, but did not participate in the study design or analysis.