Vaccine
HPV vaccines are among the newest and most expensive vaccines, presenting affordability challenges that hinder access. The HPV vaccine market is a duopoly, the two suppliers being Merck and GSK.
Vaccine and profit
Ongoing research shows that the manufacturing cost of the vaccine could be much lower. As of May 2013, Merck had already earned more than US$8.6 billion in revenues from sales of its HPV vaccine since it was first approved in 2006.59,61,144 Taking into account the 111 million doses of Gardasil sold worldwide as of May 2013145, at a manufacturing cost of US$4.50 a dose, the company made more than US$8 billion in profit (excluding the cost of research and development) on HPV vaccine sales over seven years.
Vaccine indutries
A lack of transparency and knowledge regarding existing products, characteristics and prices limits the capacity of buyers to make informed decisions.
Threat of substitute products
There are only two WHO prequalified products, each resulting in a duopoly; furthermore, the two vaccines are not substitutes for one another because of different product characteristics. When competition exists, originator products can be replaced with cheaper, qualityassured vaccines from low-cost manufacturers
The cost components for vaccines
Government
Investment choies in research and development
Pharmaceutical companies
Cost of goods
Manufacturing
Regulatory approvals
Marketing
Despite global initiatives to improve price transparency, price information remains scarce. The high prices of these vaccines in developed markets have enabled manufacturers to earn tremendous returns estimated to be at least 12 to 16 times the cost of manufacture (based on the assumption that the Gavi price represents the vaccine manufacturing cost) for Cervarix and Gardasil. - Since the vaccine only covers some high-risk types of HPV, experts still recommend that women get Pap smear screenings even after vaccination. - Additional vaccine candidate research is occurring for next generation products to extend protection against additional HPV types. - There are other high-risk HPV types that are not affected by the vaccines.The protection against HPV 16 and 18 has lasted 5 years after vaccination for Gardasil and more than 6 years for Cervarix. - Little is known about HPV knowledge in girls who have been offered the vaccine.
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