Health

How Should the World Pay for the Coronavirus Disease (COVID-19) Vaccine? – Detailed information about HEOR


The Covid-19 pandemic continues to have a devastating impact on global health and economic conditions. The Covid-19 vaccine provides a much-needed ‘exit strategy’ from this crisis. It is not clear about the different financing models for developing treatments for the health crisis that affects most countries at the same time.

Towse et.al. propose a market-based funding partnership model to the world to encourage and fund the development, production and access of a vaccine against coronavirus disease (COVID-19). The paper discusses the “push and pull framework”, first-generation covid-19 vaccine development, pre-market commitment (AMC) vs. benefit-based advance (BBAMC). Finally, the end of the lesson for future pandemic preparedness.

Encourage push and pull

  • Encourage incentives to reduce R&D costs and production infrastructure costs.
  • Pull incentives seek to offset market dynamics (by creating markets thereby reducing trade risk)
  • The authors push and pull incentives through the lens of High Income Countries (HICs), Low Income Countries (LICs) (explains the role of Gavi – Vaccine Alliance)
Illustration of COVID-19 vaccine proposals in push versus pull or a combination of both. (Source: Towse A., Firth I., 2020. How should the world pay for a COVID-19 vaccine? OHE 2020 annual lecture, Office of Health Economics. Available: https://www.ohe.org/publications/how-should-world-pay-covid-19-vaccine)

Advance Market Commitment (AMC) vs. Advance Purchase Commitment (APC)

  • AMC as a pull incentive was first used in pneumococcal vaccines to shorten vaccine delivery in LICs.
  • From a payer’s point of view, the value of APC is important to obtain scarce resources, but at a very high cost.

Using HTA and Cost Efficiency to Create Benefit-Based Advance Market Commitment (BBAMC)

  • The authors recommend that the BBAMC address uncertainties around demand and supply for vaccines, and discuss potential concerns with the approach.

Finally, the article offers three lessons about future pandemic preparedness

  • Need to build a market mechanism
  • Several country access incentives host successful vaccines for future pandemic priority products.
  • A strong financial arrangement to pay the LIC and LMIC should be pre-arranged and up and running.

Source

Towse, Adrian, et al. “How should the world pay for the Coronavirus Disease (COVID-19) vaccine?” Health value2021, www.valueinhealthjournal.com/article/S1098-3015(21)00032-2/fulltext#%20.

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