UNICEF halves price of children’s five-in-one vax with six suppliers

A UNICEF tent in Darfur. Photo courtesy of UNICEF Sudan Envoy.

In a deal that could save millions of lives, the United Nations Children’s Fund (UNICEF) has reached an unprecedented agreement with six manufacturers that slashes the price of pentavalent vaccine to half what the agency currently pays.

UNICEF said in a statement that the deal will enable it to send 450 million doses of the five-in-one vax--a crucial immunization that protects children from killer diseases diphtheria, tetanus, pertussis, hepatitis B and Hib--to 80 countries at a unit price of about 84 cents for the next three years, compared to the $1.65 per dose the agency is currently paying.

A majority of the doses will be dispensed in countries supported by Gavi, the Vaccine Alliance--an international organization that works with public and private sectors in an endeavor to increase equal access to vaccines in lower-income countries.

“For the most vulnerable children in the world, pricing can make a difference between life and death,” said Shanelle Hall, director of UNICEF’s supply and procurement headquarters, in the statement. Gavi estimates that the shots could save the lives of 5.7 million children between 2011 and 2020.

The six participants that will offer different presentations of the vaccine are Biological E, Janssen, LG Life Sciences, Panacea Biotec, Serum Institute of India, and Shantha Biotechs.

“The market for five-in-one vaccines is now a lot healthier than it was just a few years ago thanks to our collective efforts to grow a base of vaccine suppliers,” said Seth Berkley, CEO of Gavi, in a release about the new deal. He called on the vaccine industry to make sure “that sufficient quantities of quality vaccines are available at affordable prices so that countries and donors implement sustainable immunisation programmes, increase coverage and promote equitable access to vaccines.”

The first pentavalent vaccine was launched in 2001. Since then, the agency, together with Gavi and the Gates Foundation, has been leveraging its status as a gigantic customer--purchases from UNICEF itself jumped from 14.5 million doses in 2001 to more than 235 million in 2015--to boost competition by, for example, publishing the prices of all vaccines it had procured and offering several rounds of bids. Prices started to drop dramatically in 2008 when India’s Shantha entered the ring, offering its $2.90 single-dose vax compared to GlaxoSmithKline’s $3.50 version.

Gavi estimates that the average price will drop to 79 cents by 2019 with some vaccines available for as little as 60 cents.

Those six pharmas manufacture some of the most common versions of the five-in-one vax in the world: Biological E has ComBEFive, J&J’s Janssen has a part in Quinvaxem, LGLS holds the first pentavalent mixed vax developed in Korea, Panacea Biotec owns Easyfive-TT, Serum offers Pentavac PFS, and Shantha produces Shan5.

Yet the biggest name missing from the list, also the first to offer the agency such a vax in 2001, is GlaxoSmithKline. Back in 2011, the U.K.-based pharma had voluntarily suspended supply of its pentavalent vax, Tritanrix HB+Hib, for a short period of time because of problems with source materials it purchased from Novartis Vaccines. In that same year, Panacea Biotec also hit a hurdle when its version was knocked down by the World Health Organization as one of the prequalified pentavalent vaccines because of “serious inadequacies in quality assurance processes” found during a routine audit. The five-in-one vaccine also faced scrutiny in 2013 when several infant deaths were linked to the version produced by Serum in India.

According to procurement numbers posted by UNICEF, 2014 was the last year it bought pentavalent vaccines from GSK, one of the world’s largest vaccine manufacturers. At that time, the GSK version was already the most expensive among all offered for three consecutive years, with a per-dose price of $2.95. Even though it had been offering the agency that price since 2010, the others had apparently been gradually lowering their prices.

The new pricing deal struck by UNICEF is also available to governments that purchase the vax themselves. The agency estimates that it will generate over $366 million in savings for donors and for governments.

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