Vaccine access and affordability in a coordinated market under stochastic reservation prices.

摘要

Ensuring vaccine affordability and accessibility are major challenges for the fulfillment of the immunization goals of the Global Vaccine Action Plan for the decade 2011 -- 2020. Four of the five immunization goals in this plan are currently delayed because of limitations in vaccine affordability. The use of combination vaccines can help to make vaccines more accessible as long as their pricing becomes more affordable. Procurement mechanisms, such as tiered pricing and pooled procurement, have generally been used for reducing the cost of vaccine purchases, but they have not been used to ensure overall market affordability. This study extends the Antigen Bundle Pricing Problem to analyze a coordinated vaccine market and understand the effects on vaccine affordability of three factors: uncertainty regarding vaccine reservation prices, number of market segments in which customers are grouped, and the interest rate at which manufacturers recover their investment. Experimental results show that increasing the number of market segments, in which countries are grouped, positively influences vaccine affordability but reduces overall profit for manufactures. This study proposes strategies to mitigate the impact to manufacturers by determining the optimal market segmentation of target countries while considering limited access to external funding.