We’ve got to ‘fight our corner’ was the message from Novartis’ David McIntosh as he opened up the 2014 World Vaccine Congress Europe
You opened the conference this morning with the claim that ‘we need to fight our corner’ in the vaccine industry. Is the vaccine industry in trouble?
The pharmaceutical industry is broadly divided into pharma products and vaccines. The pharma area develops therapeutic medicines to treat people with illness and disease. Prevention is traditionally the area of vaccines, and, although therapeutic vaccines are emerging, the main focus of the market is still preventative vaccines.
Now there are some vaccines that have been extremely successful economically, and those profits get ploughed back in to develop new vaccines. To develop a new vaccine costs roughly a billion dollars and can take up to 20 years.
Now it’s not a simple matter any more of getting a vaccine introduced into a vaccination schedule because we have to go through the pharmacoeconomics, the cost effectiveness analysis. And as the conditions, the infections, become relatively rarer, vaccines become less cost effective because you still have to vaccinate everybody to prevent hundreds cases instead of thousands or millions of cases.
So the cost effectiveness historically of, say, the polio vaccine or the measles vaccine was clearly very high. But with newer vaccines it becomes more difficult to prove that these vaccines will be cost effective, if not cost saving. So we need to fight the corner for vaccines, because it’s all too easy to devolve to therapeutic medicines and say ‘well this is going to be very profitable this is going to be very successful. A lot of people are sick, a lot of people need medicines.’
But my final point is that we’ve got a lot of licensed vaccines, and yet they aren’t being used properly.
We’ve already heard today from the Innovative Medicines Initiative about the pertussis problem and the investment that needs to be done. We’ve got huge epidemics of measles because of vaccines scares and people not getting vaccinated against measles. We’ve got licensed vaccines that aren’t even going out on schedules. And it’s just so expensive exercise to bring a vaccine to market. So I think unless we fight the corner for vaccine development and vaccine use there will be a gradual attrition in use.
Can vaccine hesitancy pose a threat to the commercial viability of vaccines and the development of new vaccines?
I don’t want to answer that quest in terms of whether vaccine hesitancy will cause commercial problems, I want to answer that question in in the context of whether vaccine hesitancy will be a risk to individuals who will catch the disease. That’s much, much more important.
Vaccine hesitancy means that routine immunizations such as a pertussis, measles, and polio even are not being used to their full extent and individuals are at risk of the infection. But worse than that is that individuals who may be too young to be normally vaccinated, people who’ve got immune suppression, at risk medical conditions, or even just older people have double the risk of infection because of the absence of vaccination of the large proportions of the population.
From my reading of the research in the area, the solution is to persuade medical practitioners and healthcare partitions of the benefits of vaccines so they can transmit those messages to their patients. The message doesn’t always transmit to the general public terribly clearly because they don’t understand or they don’t trust the message, but they do trust their medical practitioners or their nurse. And it is up to the medical practitioner to explain the benefits of the vaccine, the risks of the vaccine, and also the overwhelming risks of the infection and of not being vaccinated.