Lois Privor-Dumm

By Lois Privor-Dumm.  A wealth of new vaccines are available that can prevent many important causes of disease.  Innovations are great, but can they reduce costs?  New technologies often require a larger up front investment while the dividends are sometimes less easily measured.  New vaccine prices can be high; looking at price alone, however, doesn’t tell the full story. Costs come in many forms, and so do savings. 

Development Innovations and Process Improvements

There are a number of new technologies that fit into the category of innovations.  Often we see technologies resulting in higher priced vaccines.  This doesn’t mean though, we’re not saving money.  Although an investment must be made to prevent disease, treatment costs can become even higher when disease threats become serious, not to mention the potential lives lost, lasting disabilities or impact on productivity.  More effective vaccines, even at higher prices, can significantly reduce cost of disease and make a lot of sense.

Understanding the importance of technologic innovation to get vaccines to the public when needed, the Centers for Disease Control and Prevention, recently announced $2 billion to help increase availability of pandemic flu vaccines.  Companies have taken novel approaches including use of surrogate human immune systems or collaborations on synthetic strains of flu vaccines that allow companies to react faster to the most prominent threats.   

Technological innovations also come in the form of vaccine delivery systems such as intranasal or Jet Injector technologies, that eliminate the cost of disposable syringes and may reduce the amount of vaccine required when immune responses are improved. For those of us who just don’t like needles – that is another benefit!

Some technologies help vaccines prevent more disease.  Development of pneumococcal common protein vaccines, hopes to broaden protection against potentially deadly forms of pneumonia and meningitis and replace current vaccines, which are difficult to develop and manufacture.

Delivery Innovations

We don’t often think of storage and handling as impacting the cost of a vaccine program significantly, but technologies that offer improved stability, eliminating need for refrigeration and reducing wastage as a result of spoilage can be as important as the vaccine itself.  In developing countries this innovation is particularly note worthy.

Project Optimize, (PATH/WHO) is rethinking the vaccine supply chain in a number of different countries.   One example of innovation in the developing world where electricity is expensive and not always available is solar battery-free refrigerators, which will now be used in Tunisia to achieve zero-energy cost supply chain.

Other innovations come in the form of something we’ve all become accustomed to using in our daily lives; cell phones and PDA’s aren’t just for email, though.

Dr. Orin Levine, the Executive Director of the International Vaccine Access Center (IVAC) at Johns Hopkins, recently wrote about an innovation that provides a different way to reduce cost.   Mozambique, with the assistance of Village Reach, a Seattle based NGO, reduced vaccine delivery costs by more than 17% – by good management and cell phones and PDA’s used to communicate inventory levels, flag problems with the cold chain and help get product to where it needs to be. Mozambique, reduced stock out rates from 80% to 1% through good management and managed to reach that “last mile.”  Good inventory management can also reduce wastage rates, which in some countries can be pretty significant and costly.  

Cell phone technology can also be used to deliver conditional cash transfers (CCTs), payments made to poor families to encourage a particular behavior such as bringing a child to a health center to receive preventative care.  Although CCTs have shown mixed results, they have only been studied in a few places and are likely to also encourage optimized use of vaccines and build demand.

Innovative Financing

The cost of the product itself is only a portion of the total vaccine cost.  To lower costs, particularly for developing countries, which account for the majority of the childhood disease burden, innovative financing mechanisms have contributed largely to the world’s ability to finance vaccine.  The Advance Market Commitment, helped revolutionize the ability to get new technologies to large numbers of people with high rates of disease nearly a decade sooner than they might have otherwise. Not only does this benefit those who receive the vaccine, but it also helps create economies of scale and more predictable demand, making development of vaccines for low income countries, a much more attractive proposition. 

Innovations on both the cost of the product and improving the efficiency of delivery systems have been shown to effectively reduce costs.  Continued thinking about the product “outside the vial” is only going to result in more vaccines, delivered to more people sooner than ever before.

* This post is part of the Disruptive Women series on innovation.

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One Response to “Innovation In And Beyond The Vial: Reducing Immunization Costs”

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