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The changing vaccine market place |
Cahiers d'études et de recherches francophones / Santé . Volume 4, Number 3, 183-7, Mai-Juin 1994, Les enjeux de la vaccination
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 Résumé
 Summary
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Author(s) : Patrick Poirot, Jacques-François Martin, Biocine, 36 quai Fulchiron, 69005 Lyon, France.. |
Summary : When Jonas Salk announced in the mid-50s the availability of a new vaccine against poliomyelitis, the world had the impression that it was now controlling infections diseases. In fact, the success of this vaccine has been considerable and although some innovations lead to the launch of vaccines against flu, measles, rubella or mumps, the world vaccine market remained remarkably stable till the mid-80s. However, since 1984 (launch of the hepatitis B vaccine) there have been very substantial changes and further change is expected in the next ten years in the world market. Today, big companies are making a concentrated supply: Pasteur Mérieux with its subsidiary Connaught, Smith Kline Beecham who acquired the Belgian company RIT, and Merck &\; Co. who is joining its forces with Pasteur Mérieux. Medium sized and small companies remain and reflect the situation of the past, but must work hard to secure their long term existence eventhough the world demand is going to double before the year 2000. Very substantial technological innovations explain to a large extent the development of the supply: progress in molecular biology, and particularly genetic engineering, lead to recombinant vaccines of which hepatitis B is the best example with worldwide sales in the range of $ 600 million a year. Similarly, conjugation technologies have allowed the development of new vaccines against meningitis, particularly Haemophilus influenzae type b. More recently, an efficacious vaccine against hepatitis A has been launched and many new products will be marketed in the next years against herpes, Lyme disease, and agents of other meningitis, etc. Compared the work of Jonas Salk in the 50s, the current international requirements necessitate huge development costs for these new vaccines. As an example, it costs $ 230 million for Smith Kline Beecham to put the hepatitis B vaccine on the market. Safety and efficacy of the new products have to be demonstrated on thousands, and sometimes tens of thousands of cases. This explains why the average price of the new vaccines is substantially higher than the traditional products. One reason for this increase in the demand is linked to the development of strategies relying upon mass vaccination. In these strategies, the fatal target is to prevent the circulation of infections agents through the immunization of substantial part of the population. In other cases, failure of policies aiming at immunizing at-risk groups also leads to a systematic immunization of infants and young children, Finally, the necessity for systematic boosters is now clear raising the world demand. A first important success of these strategies is evidences by the eradication of smallpox, and the same objective has been defined for poliomyelitis for the year 2000. The present and future innovations will also allow specific needs of individuals to be addressed: travellers, and people exposed to sexually transmitted diseases, will have access to a growing number of vaccines which will protect them in the different situations where they may be exposed to infectious agents. Finally, the EPI has had tremendous success. The coverage which was probably around 5% at the launch of the program in 1974, is now close to 80%. Three million deaths of children are avoided every year thanks to systematic immunization, and Unicef alone has multiplied by 10 in ten years the number of doses of vaccines purchased and administered. It remains to be seen to what extent the international community will be able to maintain its efforts during the coming years and to what extent it will be able to put at the disposal of the developing countries the new and expensive vaccines they badly need, in view of the existing medical needs. |
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