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Chiron Vaccines Feedback on Financing Vaccines for the 21 st Century Clement Lewin VP Govt. Affairs & Immunization Policy June, 2004 Case study: Chiron’s investment of ~$800 million in the US influenza vaccine market Market size & Growth Potential

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chiron vaccines feedback on financing vaccines for the 21 st century

Chiron Vaccines Feedback on Financing Vaccines for the 21st Century

Clement Lewin

VP Govt. Affairs & Immunization Policy

June, 2004

currently under the right circumstances companies will invest in the us vaccine market
Case study: Chiron’s investment of ~$800 million in the US influenza vaccine market

Market size & Growth Potential

~80 million people immunized and vaccination recommended for ~185 million people

A commitment to achieving Healthy People 2010 goals

Public / Private partnerships in place to increase coverage rates

The right financing conditions

Reimbursement levels not a barrier to immunization

Existing pricing levels justify long-term investment

Capital investment in production capacity to meet demand

Research and development investment for next generation products

Currently, under the right circumstances companies will invest in the US vaccine market

Financing was only one of the factors impacting Chiron’s decision

chiron commends the report highlighting issues with the current system
Low coverage rates in adolescents and adults compared to children

Delays in funding coverage for newly recommended vaccines

The negative impact on supply of statutory price caps imposed at the time VFC was enacted

Chiron commends the report highlighting issues with the current system
however the successes of the current system are not emphasized
Immunization coverage rates have reached unprecedented levels in children

Progress in reducing geographic and socio-economic disparities

New vaccines have been added to the immunization schedule

Varicella, Hepatitis A, Pneumoconjugate

The majority of children have access to new vaccines

Single tiered system as opposed to two-tiered system

More children are being vaccinated in their “medical home”

However, the successes of the current system are not emphasized

Current system has reduced the burden of vaccine preventable disease in children

will the iom proposals assure access to vaccines or sustain their future availability
Impact of non-price factors on vaccine supply and coverage

Perceptions of value of vaccines

Increasing regulatory burden

Implementation of the voucher system

Will replacing the system with a government subsidy and voucher plan improve immunization rates?

Can such a program be administered efficiently?

Pricing based on a calculation of societal benefit

Will additional risks to vaccine development be created by an inability to project price?

Will calculation of the societal benefit of vaccines could turn into a “black hole”?

Will calculation turn into a price cap?

Will the IOM proposals assure access to vaccines or sustain their future availability?

Ir is unclear whether the proposal is workable or will be better than the current system

increasing requirement for pre licensure data

Rotateq

75,000?

FluMist

38,000

Prevnar

39,000

Varivax

11,000

Increasing Requirement for Pre-Licensure Data

PedvaxHIB™

6,000

Recombivax HB

1,200

1980

2010

will the iom proposals assure access to vaccines or sustain their future availability7
Impact of non-price factors on vaccine supply and coverage

Perceptions of value of vaccines

Increasing regulatory burden

Implementation of the voucher system

Will replacing the system with a government subsidy and voucher plan improve immunization rates?

Can such a program be administered efficiently?

Pricing based on a calculation of societal benefit

Will additional risks to vaccine development be created by an inability to project price?

Will calculation of the societal benefit of vaccines could turn into a “black hole”?

Will calculation turn into a price cap?

Will the IOM proposals assure access to vaccines or sustain their future availability?

Ir is unclear whether the proposal is workable or will be better than the current system

conclusions
Incentives for vaccine development at Chiron are not increased by a system of subsidies, mandates and vouchers

Lack of clarity on methodology & implementation mechanisms

Societal benefit calculation may create de-facto “price cap”

Providing financing will not necessarily lead to increased coverage rates in adults and adolescents

Need to learn from experience in children

Incremental improvements to the current system should be considered

Increasing 317 Funding or expanding VFC coverage to the underinsured

Increasing providerchoice of vaccines

Removing price caps for older vaccines

Improving adolescent and adult immunization infrastructure

Conclusions

Not clear that this dramatic shift is required or desirable