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新興市場におけるワクチン市場へのアクセス

Vaccines Market Access in Emerging Markets

発行 Datamonitor Healthcare 商品コード 912146
出版日 ページ情報 英文 76 Pages
納期: 即日から翌営業日
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新興市場におけるワクチン市場へのアクセス Vaccines Market Access in Emerging Markets
出版日: 2019年08月29日 ページ情報: 英文 76 Pages
概要

新興市場は世界のワクチン市場の約18%を構成しており、その規模は240億米ドル以上です。しかし、これは過小評価であるという指摘もあり、一部のオブザーバーは全体市場が2020年代半ばまでに500億米ドルへ達すると予測しています。

当レポートでは、新興市場におけるワクチン市場について調査し、市場情勢、各地域における動向、市場アクセスへの戦略・課題・機会などについて分析しています。

概要

市場情勢

  • 市場評価
  • 国・多国間アクセス向けの戦略
  • 国際的ステークホルダーの分析
  • 参考資料

アジア太平洋

  • 中国の民間市場はダイナミックである一方、NIP価格は停滞
  • インドのワクチン市場は産業がグロバル化するにつれ緩やかに改善
  • 中規模のアジア市場は構造的な課題に直面
  • 参考資料

ラテンアメリカ

  • 調達の一元化はメーカーに課題となるだけではなく、効率向上ももたらす
  • 参考資料

中東欧

  • ロシアのワクチン市場は近代化しつつある
  • EU加盟国において、技術の高度化と商業的な機会は不均衡
  • 参考資料

中東・アフリカ

  • 中東において、ワクチンの輸入依存度は低下しつつある
  • 参照価格はMENA地域にわたって拡大
  • トルコは「自己調達」市場の限界を示す
  • サハラ以南アフリカは、その巨大な可能性を実現していない
  • 参考資料

結論

  • 中間所得諸国は現代のワクチンメーカーにとって最優先
  • GAVI (The Global Alliance for Vaccines and Immunization) は新たな市場を創出
  • ビジネス環境の監視
  • "Not playing" は選択肢ではない
  • 未開拓の市場を特定し、範囲拡大のためのコンセンサスを構築する

付録

目次
Product Code: DMKC0207695

Overview

Emerging markets account for approximately 18% of the global vaccines market, which is valued at more than $24bn. However, there are indications that this is an underestimate, and some observers forecast that the overall marketplace will reach $50bn by the mid-2020s. Gavi - a multilateral agency principally funded by the Gates Foundation - accounts for some $2bn, procured via the United Nations agency UNICEF. The remainder is represented by "self-procuring" middle-income emerging markets, including the BRIC-MT nations (Brazil, Russia, India, China, Mexico, and Turkey) and many smaller, high-growth markets. Gavi is part of an international ecosystem of fundholders, financiers, researchers, and experts, some of whom are more focused on cost containment than rewarding innovation, as is evidenced by attempts to improve "transparency" in international vaccines pricing.

It is expected that Gavi's dose demand will plateau in the mid-2020s, as more countries that are currently reliant on the agency's funding for vaccines transition towards national procurement in their National Immunization Programs (NIPs). Given flat Gavi prices for modern vaccines, and stretched production volumes, multinationals are likely to focus even more intensively on middle-income countries in the future. In addition, manufacturers based in developing countries already account for a 40% share of Gavi purchases, and their influence in middle-income countries is growing commensurately.

Nevertheless, some multilateral mechanisms, such as the Pan American Health Organization (PAHO) Revolving Fund, offer opportunities for manufacturers of modern, differentiated vaccines. Emerging markets with "functional" National Immunization Technical Advisory Groups (NITAGs) offer the best long-term potential for multinationals, as value arguments are more likely to resonate; however, payers may exploit economic concepts such as budget impact and cost effectiveness to restrict access to the smallest possible population. In order to mitigate these risks, innovator companies can deploy quantitative and qualitative indicators to assess the market access environment in middle-income emerging markets, from population data to "functionality" criteria for regulators, payers, and technical advisors. In some markets, aggressive cost-containment measures, such as international reference pricing and "winner-takes-all" procurement practices, prohibit entry.

Asia represents the largest opportunity for modern vaccines in population terms, with more than 50 million births per year and a sizable willingness to pay among private individuals. This is an attractive proposition for multinationals, as prices for most NIP-funded vaccines are unacceptably low. India has significantly expanded its NIP in recent years, with pilots at sub-national level driving the changes, but funding continues to lag behind the country's enormous unmet need for vaccines. The smaller Asia-Pacific markets present some opportunities; Malaysia has a strong marketplace for foreign branded vaccines, but in neighboring Thailand, health technology assessment (HTA) presents an evidentiary hurdle, as well as a justification for negative decisions. Fragmented funding and incomplete reforms to healthcare systems pose physical and financial barriers to new vaccines in many middle-income Southeast Asian markets.

Latin America is the second-largest region in our survey, and - apart from Mexico - all member states of the PAHO participate in the Revolving Fund, a pooled procurement mechanism for the region. The Revolving Fund allows smaller member states to exploit economies of scale achieved by the larger countries, notably Brazil, which has also introduced cost-effectiveness gate-keeping, in addition to benefiting from PAHO's "lowest price" strategy. Technology transfer is a key goal for regional policymakers, although advanced capabilities in vaccines development and manufacturing are isolated.

In Central and Eastern Europe, technical capability and ability to pay appear inversely proportional to the size of the potential market. Russia is considering major expansions to its NIP, but access remains better at the regional level, although so-called "localization" policies are an additional burden. The Eastern European EU member states offer small but solid long-term prospects, although Romania is a cause for concern.

The Middle East and Africa is essentially three regions. The North African markets conduct largely national procurement, while the wealthy Gulf Cooperation Council (GCC) member states pressurize prices through joint tenders. In sub-Saharan Africa, most markets are Gavi-dependent. The exception is South Africa, which is attempting to merge local production and government procurement via a single entity. While the wealthier markets still represent solid opportunities, as in many emerging markets, the region continues to transition away from reliance on modern vaccines to a mixed system of indigenous production, low-cost basic vaccines, and a limited space for innovative products.

To respond to the market access challenges and opportunities posed by developing countries, which differ fundamentally from high-income countries, no single approach is feasible. Instead, quantitative and qualitative indicators for local populations, payer capabilities, and funding opportunities can inform strategies. Full disengagement from multilateral or national fundholders is not advisable, but pricing and access strategies can be tailored to each market, depending on its attractiveness. These measures include arguing for wider coverage - especially among risk groups - and convincing payers to introduce non-price criteria into their decision-making. In terms of both coverage and new technologies, untapped markets exist, but should be cautiously evaluated for their price and volume opportunities.

TABLE OF CONTENTS

OVERVIEW

MARKET LANDSCAPE

  • Market valuations
  • Strategies for national and multilateral access
  • International stakeholder analysis
  • Bibliography

ASIA-PACIFIC

  • China's private market is dynamic, while NIP prices stagnate
  • India's vaccine market slowly improves as industry globalizes
  • Mid-sized Asian markets face structural challenges
  • Bibliography

LATIN AMERICA

  • Centralizing procurement challenges manufacturers, as well as delivering efficiencies
  • Bibliography

CENTRAL AND EASTERN EUROPE

  • Russia's vaccine market is modernizing
  • In EU member states, technical sophistication and commercial opportunities are misaligned
  • Bibliography

MIDDLE EAST AND AFRICA

  • In the Middle East, vaccine import dependency is eroding
  • Reference pricing is expanding across the MENA region
  • Turkey illustrates the limitations of "self-procurement" markets
  • Sub-Saharan Africa is yet to realize its enormous potential
  • Bibliography

CONCLUSIONS

  • Middle-income countries are the priority for manufacturers of modern vaccines
  • Gavi creates new markets
  • Monitor the business environment
  • "Not playing" is not an option
  • Identify untapped markets and build the consensus for expanded coverage

APPENDIX

  • Report scope

LIST OF FIGURES

  • Figure 1: Leading middle-income emerging markets: vaccine funding status (one of two), 2019
  • Figure 2: Leading middle-income emerging markets: vaccine funding status (two of two), 2019
  • Figure 3: Birth cohorts and government vaccine investment in middle-income countries, by country, 2018
  • Figure 4: UNICEF and PAHO vaccine prices, 2018
  • Figure 5: Middle-income vaccine markets - investment dashboard (one of two)
  • Figure 6: Middle-income vaccine markets - investment dashboard (two of two)
  • Figure 7: Stakeholder map - China vaccines market
  • Figure 8: Timeline of updates to India's Universal Immunization Program, 2002-18
  • Figure 9: Vaccines stakeholder map: Thailand Universal Healthcare Scheme
  • Figure 10: Mexico: vaccine stakeholder map
  • Figure 11: International reference pricing in the Middle East and North Africa
  • Figure 12: Turkey: vaccine stakeholder map

LIST OF TABLES

  • Table 1: Leading multilateral immunization agencies
  • Table 2: Comparison: Drug versus vaccine business models in emerging markets
  • Table 3: Asia-Pacific: regional SWOT analysis
  • Table 4: A long-standing presence and constructive engagement can drive access
  • Table 5: Stakeholder summary: mid-sized Asian markets
  • Table 6: An immature market access environment can be hazardous for innovators
  • Table 7: Latin America: regional SWOT analysis
  • Table 8: Latin America: regional stakeholder summary
  • Table 9: Differentiated strategies are needed for the largest Latin American markets
  • Table 10: Central and Eastern Europe: regional SWOT analysis
  • Table 11: Central and Eastern Europe: regional stakeholder summary
  • Table 12: Technology transfer may help mitigate payer reluctance to fund new vaccines
  • Table 13: Middle East and Africa: regional SWOT analysis
  • Table 14: Middle East and Africa: regional stakeholder summary
  • Table 15: The MenAfriVac story will be difficult to replicate