Review of vaccine price data

Transcription

1 Review of vine prie dt Sumitted y WHO Europen Region Memer Sttes through the WHO/UNICEF Joint Reporting Form for 2013

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3 Review of vine prie dt Sumitted y WHO Europen Region Memer Sttes through the WHO/UNICEF Joint Reporting Form for 2013

4 Astrt This report ims to ssist ntionl immuniztion progrmme mngers, helth udgeting experts nd experts responsile for vine prourement in essing, understnding nd utilizing ville vine mrket informtion in order to improve the effiieny of vine prourement nd ountries ilities to mke finnilly sustinle, informed deisions on vine prourement nd new vine introdution. It onsolidtes dt tht were olleted for the yer 2013 nd provided y 23 Memer Sttes of the WHO Europen Region through the Joint Reporting Form (JRF) of WHO nd the United Ntions Children s Fund (UNICEF). The report provides rief overview of the vilility nd trnspreny of vine priing informtion t the ountry level, the vine prourement mehnisms, the proured vines nd vine prie informtion for eh of the individul vine produts. Individul prourement reords inlude some of the vriles expeted to hve potentil impt on prie, inluding the ountry inome group, volume of prourement, produt formultion nd presenttion, delivery terms nd vine prourement mehnism. World Helth Orgniztion 2015 All rights reserved. The Regionl Offie for Europe of the World Helth Orgniztion welomes requests for permission to reprodue or trnslte its pulitions, in prt or in full. Keywords DATA ANALYSIS PRICING UNICEF VACCINES WORLD HEALTH ORGANIZATION ISBN Address requests out pulitions of the WHO Regionl Offie for Europe to: Pulitions WHO Regionl Offie for Europe UN City, Mrmorvej 51 DK-2100 Copenhgen Ø, Denmrk Alterntively, omplete n online request form for doumenttion, helth informtion, or for permission to quote or trnslte, on the Regionl Offie wesite ( The designtions employed nd the presenttion of the mteril in this pulition do not imply the expression of ny opinion whtsoever on the prt of the World Helth Orgniztion onerning the legl sttus of ny ountry, territory, ity or re or of its uthorities, or onerning the delimittion of its frontiers or oundries. Dotted lines on mps represent pproximte order lines for whih there my not yet e full greement. The mention of speifi ompnies or of ertin mnufturers produts does not imply tht they re endorsed or reommended y the World Helth Orgniztion in preferene to others of similr nture tht re not mentioned. Errors nd omissions exepted, the nmes of proprietry produts re distinguished y initil pitl letters. All resonle preutions hve een tken y the World Helth Orgniztion to verify the informtion ontined in this pulition. However, the pulished mteril is eing distriuted without wrrnty of ny kind, either express or implied. The responsiility for the interprettion nd use of the mteril lies with the reder. In no event shll the World Helth Orgniztion e lile for dmges rising from its use. The views expressed y uthors, editors, or expert groups do not neessrily represent the deisions or the stted poliy of the World Helth Orgniztion. Imges M. Bring over WHO pge VI WHO/I. Sergienko pge 6, 19 & 22

5 III Contents ACKNOWLEDGEMENTS... IV ABBREVIATIONS... V INTRODUCTION... 1 GLOBAL RECOGNITION OF THE NEED FOR VACCINE PRICE TRANSPARENCY... 1 WHO EUROPEAN REGION RESPONSE ON VACCINE PRICE TRANSPARENCY... 2 REPORTING OF VACCINE PRICE DATA... 3 AVAILABILITY AND TRANSPARENCY OF VACCINE PRICING INFORMATION... 4 VACCINE PROCUREMENT MECHANISMS... 5 PROCURED VACCINES... 7 MANUFACTURER BASE OF PROCURED VACCINES... 9 REPORTED VACCINE PRICES COUNTRY INCOME LEVEL AND VACCINE PRICES PAID VACCINE PROCUREMENT VOLUMES AND PRICE VACCINE PRESENTATION AND PRICE VACCINE FORMULATION AND PRICE WHO S V3P PLATFORM REFERENCES APPENDIX 1. JRF TEMPLATE USED TO COLLECT VACCINE PRICING DATA FOR APPENDIX 2. MEMBER STATES REPORTING STATUS OF VACCINE PRICING DATA IN THE ANNUAL WHO/UNICEF JRF, APPENDIX 3. COUNTRY-SPECIFIC VACCINE PRICE DATA BY INDIVIDUAL PRODUCT APPENDIX 4. NATIONAL CURRENCY EXCHANGE RATES TO US DOLLARS APPENDIX 5. CLASSIFICATION OF MEMBER STATES BY COUNTRY INCOME GROUP APPENDIX 6. LIST OF WHO PREQUALIFIED VACCINES AS OF 1 JANUARY APPENDIX 7. OTHER VACCINE PRICE DATA SOURCES... 51

6 Aknowledgements This pulition ws developed y the Vine-preventle Diseses nd Immuniztion Progrmme of the WHO Regionl Offie for Europe nd ws oordinted y Oleg Benes, Tehnil Offier t the Regionl Offie, within the frmework of the glol WHO Vine Produt, Prie nd Prourement (V3P) Projet. The following individuls hve ontriuted to the prodution of the pulition nd their inputs re knowledged with sinere grtitude: Shwn S. Gilhrist, independent onsultnt; Srh Shmitt, independent onsultnt, finning, plnning nd prourement; Stephnie Mrit, Vine Produt, Prie nd Prourement (V3P) Projet, WHO hedqurters; Tni Cernushi, Tehnil Offier, Vine Priing, Supply nd Prourement, WHO hedqurters; Mihel Hinsh, independent onsultnt, Vine Produt, Prie nd Prourement (V3P) Projet, WHO hedqurters; Miloud Kddr, Helth Eonomist, WHO hedqurters; Cthrin de Kt-Reynen, Consultnt, Vine-preventle Diseses nd Immuniztion, WHO Regionl Offie for Europe.

7 V Arevitions P ellulr pertussis BCG ille Clmette Guérin (tuerulosis) vine EVAP Europen Vine Ation Pln GNI gross ntionl inome FCA free rrier Influenz_dult sesonl influenz vine, dult formultion PCV pneumool onjugte vine PFS pre-filled syringe DT diphtheri nd tetnus toxoids, peditri formultion DTP diphtheri nd tetnus toxoids nd ellulr pertussis vine, peditri formultion DTP-Hi diphtheri nd tetnus toxoids nd ellulr pertussis nd Hemophilus influenze type vine DTP-Hi-HepB-IPV diphtheri nd tetnus toxoids nd ellulr pertussis, Hemophilus influenze type, heptitis B nd intivted poliovirus vine DTP-Hi-IPV diphtheri nd tetnus toxoids nd ellulr pertussis, Hemophilus influenze type nd intivted poliovirus vine DTP-IPV diphtheri nd tetnus toxoids nd ellulr pertussis nd intivted poliovirus vine DT-IPV diphtheri nd tetnus toxoids nd intivted poliovirus vine DTP diphtheri tetnus pertussis vine DTwP diphtheri nd tetnus toxoids nd whole-ell pertussis vine, peditri formultion DTwP-Hi-HepB diphtheri nd tetnus toxoids nd whole-ell pertussis, Hemophilus influenze type nd heptitis B vine GVAP Glol Vine Ation Pln HepA heptitis A vine HepAHepB heptitis A nd heptitis B vine HepB_dult heptitis B vine, dult formultion HepB_peditri heptitis B vine, peditri formultion Hi Hemophilus influenze type HiMenC Hemophilus influenze type nd meningool serogroup C vine HIC high-inome ountry HPV humn ppillomvirus Inoterms Set of rules pulished y the Interntionl Chmer of Commere defining the responsiilities of sellers nd uyers for the delivery of goods under sles ontrts CIF ost insurne nd freight CIP rrige nd insurne pid to DAP delivered t ple DDP delivered duty pid EXW ex works Influenz_peditri sesonl influenz vine, peditri formultion IPV intivted poliovirus vine JE Jpnese enephlitis live ttenuted vine JE_intd Jpnese enephlitis intivted vine JRF WHO/UNICEF Joint Reporting Form LIC low-inome ountry LMIC lower-middle-inome ountry Men AC ivlent meningool A nd C vine Men ACWY qudrivlent meningool A, C, W nd Y vine MenC_onj meningool C onjugte vine MIC middle-inome ounty MMR mesles, mumps nd ruell vine MMRV mesles, mumps, ruell nd vriell vine MR mesles ruell vine OPV orl poliovirus vine Pneumo_ps pneumool polyshride vine TBE tik-orne enephlitis Td tetnus nd diphtheri vine, dult/dolesent formultion TdP tetnus, diphtheri nd ellulr pertussis vine, dult/dolesent formultion Tdp-IPV tetnus, diphtheri, ellulr pertussis nd intivted poliovirus vine, dult/ dolesent formultion TT tetnus toxoid Typhoid-heptitis A typhoid fever nd heptitis A vine UMIC upper-middle-inome ountry UNICEF United Ntions Children s Fund UNICEF SD UNICEF Supply Division V3P vine produt, prie nd prourement WAP weighted verge prie wp whole-ell pertussis YF yellow fever

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9 INTRODUCTION 1 Introdution Informtion ontined in the report ws provided y Memer Sttes of the WHO Europen Region through the nnul Joint Reporting Form (JRF) of WHO nd the United Ntions Children s Fund (UNICEF). Reporting ountries re solely responsile for the ury of the dt provided. Users should exerise ution when interpreting vine prie dt, tking into ount speifi ontexts, irumstnes nd ftors tht my ffet pries pid y individul ountries. The utilized prie mesures im to illustrte prie vritions nd enourge more trnspreny to understnd the underlying uses. They should not e onsidered representtive or set ny prie enhmrks. Glol reognition of the need for vine prie trnspreny In reent yers, onsiderle emphsis hs een pled on the importne of prie trnspreny in vines. The lk of prie trnspreny hs een rised in mny regionl nd glol meetings, nd ffordle priing remins onern for mny ountries. Vine priing is onsiderly less trnsprent thn priing for other lifesving phrmeutils. Efforts hve een mde y few mnufturers to pulish some of the riteri used to estlish priing in some mrkets. However, no single mnufturer reports ll the speifi pries in ll mrkets in whih they sell. The role of inresing trnspreny hs, therefore, een tken up y the purhsing side; oth UNICEF Supply Division (SD) nd the Pn Amerin Helth Orgniztion (PAHO) Revolving Fund hve mde onsiderle improvements to vine prie trnspreny y mking pulilly ville some of the prie rrngements they hve in ple with some mnufturers. Other efforts to improve vine prie trnspreny inlude the Médeins Sns Frontières Right-Shot pulition (1), the GAVI mrket-shping efforts prtiulrly for GAVI grduting ountries (2) nd the WHO Vine, Produt, Prie nd Prourement (V3P) Projet (3). Memer Sttes endorsed the Glol Vine Ation Pln (GVAP) t the Sixty-fifth World Helth Assemly in resolution WHA65.17 (4 5). In the nnul progress report on the Dede of Vines nd Glol Vine Ation Pln, informtion on vine pries t the glol level ws requested (6). This request stems from the onern tht middle-inome ountries (MICs), not supported y donor funding, re prtiulrly hllenged to introdue newer nd more ostly vines. Monitoring GVAP progress, the WHO Strtegi Advisory Group of Experts on immuniztion defined vine ffordility s one of five priority prolems in GVAP implementtion nd lled for greter trnspreny in this re y enourging ountries to exerise more ontrol on vine mrket nd ommit to shring vine priing informtion nd working together to llow evidene-sed ssessment of the sle nd sope of mrket imlnes, nd llow solutions to e developed one the prolems re understood (7). The most ruil spet to ll of these efforts is the willingness of ountries to shre priing dt nd informtion. Strong ommitment for improved trnspreny from the purhsing side is essentil to ensure ontinued improvements in ffordle nd equitle priing to ll ountries.

10 2 REVIEW OF VACCINE PRICE DATA WHO Europen Region response on vine prie trnspreny The Europen Vine Ation Pln (EVAP), dopted y the 64th session of the WHO Regionl Committee for Europe on 18 Septemer 2014, sets regionl vision nd gols for immuniztion nd ontrol of vine-preventle diseses from 2015 to 2020 nd eyond. Inresing ess to qulity-ssured vines t ffordle pries is one key omponent to hieving sustinle introdution of new vines. In this ontext, EVAP lls on Memer Sttes to Support prie trnspreny efforts regionlly nd glolly through inresed shring of vine prie informtion. (8). In 2014, the JRF ws used to ollet informtion on the pries of proured vines from Memer Sttes of the WHO Europen Region (Appendix 1). The olleted dt estlished minimum frmework for shring vine priing informtion t the regionl level. It integrtes nd ontriutes to the roder glol efforts imed t inresing trnspreny of vine pries to empower ountries in mking informed vine introdution deisions. This report is designed to onsolidte the olleted dt nd informtion to report k to Memer Sttes. The intention is to ssist ntionl immuniztion progrmme mngers, helth udgeting experts nd experts responsile for vine prourement in essing, understnding nd utilizing ville vine mrket informtion, leding to improved effiieny of vine prourement nd the ility to mke finnilly sustinle, informed deisions on vine prourement nd new vine introdution. The dt olleted in 2014 refers to vines proured during the previous yer, Twenty-three Memer Sttes sumitted omplete dt (see Appendix 2). This report provides rief overview of the vilility nd trnspreny of vine priing informtion t the ountry level, the vine prourement mehnisms nd the proured vines. In ddition, it inorportes stndrdized tles, displying vine prie informtion for eh of the individul vine produts (see Appendix 3). Vine prie dt provided y individul ountries re expressed in US dollrs (using the World Bnk s verge nnul exhnge rtes for 2013 in Appendix 4) (9) nd rnked from minimum to mximum vlue. Averge prie estimtes (medin vlue nd weighted verge prie (WAP)) were lso lulted. Individul prourement reords inlude some of the vriles expeted to hve potentil impt on prie, inluding the ountry inome group, volume of prourement, produt formultion nd presenttion, delivery terms nd vine prourement mehnism. Limittions of dt The dt provided in this report should not e overnlysed s very few onlusions n e drwn from this limited dt set. In ollting this dt nd the report, every ttempt ws mde to mke the informtion s ler s possile nd to limit misinterprettion of the dt. This is good strt to regionl efforts to improve vine prie trnspreny. However, room for improvement exists in the oming yers. It is hoped nd ntiipted tht over time: the tools for dt olletion will improve nd e simple for the ountries to omplete; the understnding of the importne of providing dt will improve, resulting in ll Memer Sttes in the Region providing these importnt dt nnully; nd the signifine of dt ury, whih llows for improved nlysis nd omprility, will led to improved understnding of the dt nd how they n e utilized.

11 REPORTING OF VACCINE PRICE DATA 3 Reporting of vine prie dt The olletion nd reporting of vine prie dt is intended to improve mrket trnspreny, redue the symmetry of informtion ville to purhsers nd ssist in mking priing pproprite, fir nd effiient. Of the 53 Memer Sttes in the Region, 47 sumitted their JRF reports for 2013 (see Appendix 2). Twenty-three Memer Sttes (43%) responded to the request to omplete the vine prie setion of the 2013 JRF. Prtil dt on the vine prourement system nd proured produts were provided y seven dditionl Memer Sttes. Therefore the denomintors in the report vry ording to the numer of reporting Memer Sttes ginst speifi inditor. Memer Sttes from ll inome groups shred vine prie dt. The upper-middle- nd high-inome groups showed lower prtiiption rtes in sumitting omplete priing dt 33% (4/12) nd 39% (13/33) ordingly. Tle 1 shows the distriution of ountries reporting vine priing informtion y inome groups, s per the World Bnk s lssifition (10). See Appendix 5 for detiled lssifition of Memer Sttes y inome group. TABLE 1. Reported vine priing dt through the JRF y ountry inome group JRF reports With omplete With inomplete Country inome group (no. of ountries) Sumitted (%) priing dt (%) priing dt (%) High-inome ountry (HIC) (33) Upper-middle-inome ountry (UMIC) (12) Lower-middle-inome ountry (LMIC) (6) Low-inome-ountry (LIC) (2) Totl (53) 47 (89%) 23 (43%) 7 (13%) Key point Memer Sttes of ll inome groups shred vine prie dt through the nnul JRF reports. The prtiiption rte ws lower mong upper-middle-inome nd high-inome ountries.

12 4 REVIEW OF VACCINE PRICE DATA Avilility nd trnspreny of vine priing informtion The JRF report inluded three questions imed to ssess the vilility of vine priing informtion t the ntionl level, existing prties of pulishing ntionl vine priing dt in the puli domin, nd the presene of legl provisions tht prevent shring of vine priing informtion. The numer of ountries responding to eh question vried; therefore, different denomintors re used in lultions. Key point Vine priing informtion is widely ville in Memer Sttes of different inome groups; however, these dt re rrely pulished or mde essile. Limited legl restritions provide n opportunity to inrese vine priing trnspreny nd expnd enefits from etter informed deision-mking on vine prourement nd new vine introdution. Of the reporting Memer Sttes, 21 out of 29 (72%) reported tht vine priing informtion ws ville t the ntionl level. Fewer HICs (65%) reported hving vine priing informtion ville ompred to ountries of lower inome groups (83%). Deentrlized vine prourement to suntionl uthorities or outsouring to privte prourement servies in some HICs might explin the differene. Nine out of 25 reporting Memer Sttes (36%) pulish vine priing informtion in the puli domin. Restritions on the ility to shre vine prie informtion were reported y three out of 26 reporting Memer Sttes (12%), ll of whih re HICs. In one se, referene ws mde to speifi legl provisions estlishing the trnspreny restrition, while two others referred to n existing prtie of keeping vine priing dt onfidentil. A summry of vilility nd trnspreny of vine priing informtion is provided in Tle 2. TABLE 2. Avilility nd trnspreny of vine priing informtion y ountry inome group Vine prie informtion Aville t ntionl level Pulished in puli domin Restrited y legl provisions Country inome group Totl no. Totl no. Totl no. (no. of ountries) Yes No of nswers Yes No of nswers Yes No of nswers HIC (33) UMIC (12) LMIC (6) LIC (2) Totl (53)

13 VACCINE PROCUREMENT MECHANISMS 5 Vine prourement mehnisms Informtion regrding the use of different vine prourement mehnisms ws provided y 29 Memer Sttes, whih reported purhsing vines through government genies, interntionl prourement genies or omintion of oth. All HICs tht reported through the JRF nd most UMICs utilize ntionl prourement mehnisms operted y government genies. LICs nd LMICs reported enefiting lrgely from the prourement servies provided y interntionl prourement genies suh s UNICEF SD. Tle 3 summrizes the vine prourement mehnisms used. TABLE 3. Prourement mehnisms reported y Memer Sttes in 2013 y ountry inome group Prourement mehnism Ntionl Interntionl prourement y prourement Other, Totl ountry Country inome group government geny geny inluding donors responses HIC (33) UMIC (12) LMIC (6) LIC (2) Totl (53) Eh Memer Stte reported one or more pplile prourement mehnisms.

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15 PROCURED VACCINES 7 Proured vines Informtion on the nmes of the vine produts proured ws sumitted y 30 Memer Sttes nd inluded dt for one or more produts. In totl, 41 different vine produts were proured in Of these, 13 produts were proured in multiple produt presenttions, inluding pre-filled syringes (PFS) nd single or multidose mpoules nd vils. The list of proured vines is in Fig. 1, rnked y frequeny of the numer of prouring ountries per produt. FIG. 1. Frequeny of proured vines reported y 30 Memer Sttes VACCINES Typhoid-heptitis A TdP-IPV TBE MMRV Men AC JE_Intd JE HiMenC YF MR Mesles HepAHepB DTP-Hi Typhoid fever Influenz_peditri Men ACWY Pneumo_ps HepA DTP Vriell Rotvirus MenC_onj TT Hi DTwP-Hi-HepB DTP-Hi-HepB-IPV TdP IPV HepB_dult DTwP OPV Influenz_dult HPV DTP-IPV DT PCV DTP-Hi-IPV Td BCG HepB_peditri MMR different vine produts were proured in NO. OF COUNTRIES

16 8 REVIEW OF VACCINE PRICE DATA BCG: ille Clmette Guérin (tuerulosis) vine; DT: diphtheri nd tetnus toxoids, peditri formultion; DTP: DT nd ellulr pertussis vine, peditri formultion; DTP-Hi: DTP nd Hemophilus influenze type vine; DTP-Hi-HepB-IPV: DTP, Hemophilus influenze type, heptitis B nd intivted poliovirus vine; DTP-Hi-IPV: DTP, Hemophilus influenze type nd intivted poliovirus vine; DTP-IPV: DTP nd intivted poliovirus vine; DTwP: diphtheri nd tetnus toxoids nd whole-ell pertussis vine, peditri formultion; DTwP-Hi-HepB: DTwP, Hemophilus influenze type vine nd heptitis B vine; HepA: heptitis A vine; HepAHepB: heptitis A nd heptitis B vine; HepB_dult: heptitis B vine, dult formultion; HepB_peditri: heptitis B vine, peditri formultion; Hi: Hemophilus influenze type ; HiMenC: Hi nd meningool serogroup C vine; HPV: humn ppillomvirus; Influenz_dult: sesonl influenz vine, dult formultion; Influenz_peditri: sesonl influenz vine, peditri formultion; IPV: intivted poliovirus vine; JE: Jpnese enephlitis live ttenuted vine; JE_intd: Jpnese enephlitis intivted vine; Men AC: meningool AC vine; Men ACWY: meningool ACWY vine; MenC_onj: meningool C onjugte vine; MMR: mesles, mumps nd ruell vine; MMRV: mesles, mumps, ruell nd vriell vine; MR: mesles ruell vine; OPV: orl poliovirus vine; PCV: pneumool onjugte vine; Pneumo_ps: pneumool polyshride vine; TBE: tik-orne enephlitis; Td: tetnus nd diphtheri vine, dult/dolesent formultion; TdP: Td nd ellulr pertussis vine, dult/dolesent formultion; Tdp-IPV: TdP nd IPV, dult/dolesent formultion; TT: tetnus toxoid; Typhoid-heptitis A: typhoid fever nd heptitis A vine; YF: yellow fever Aross the 30 reporting Memer Sttes, MMR ws the most ommonly proured vine, followed y HepB_peditri, BCG nd Td vines. Comintions of diphtheri tetnus pertussis- (DTP) nd IPV-ontining vines vried etween ountries: the most ommon proured produt ws pentvlent DTP-Hi-IPV (17 ountries), followed y DTP-IPV (13 ountries). Of the more reently introdued vines, PCV nd HPV vines were proured in 15 nd 13 Memer Sttes, respetively. Rotvirus vine ws reported y 7 nd vriell vine y 6 Memer Sttes. Vines were proured in vrious presenttions, from single dose to 20 doses per primry ontiner (Tle 4). Most vines (70%) were in single dose presenttions, followed y 10 dose presenttions (21%) nd 20 dose presenttions (4%). BCG nd OPV vines were only in 10 or 20 dose presenttions. Multidose presenttions were represented minly y trditionl ntigens nd omintions: DT, DTwP, heptitis B, MMR, Td nd TT nd vines. TABLE 4. Frequeny of proured vine presenttions Vine presenttion Vine presenttion (doses/primry ontiner) (doses/primry ontiner) Vine produt Vine produt BCG Mesles 2 1 DT Men AC 1 DTP 5 Men ACWY 2 DTP-Hi 1 MenC_onj 5 DTP-Hi-HepB-IPV 7 MMR DTP-Hi-IPV 17 MMRV 1 DTP-IPV 13 MR 2 DTwP OPV 13 4 DTwP-Hi-HepB Pneumo_ps 3 HepA 5 PCV 17 HepAHepB 3 Rotvirus 9 HepB_dult 8 1 TBE 2 HepB_peditri Td Hi 6 TdP 7 HiMenC 1 Tdp-IPV 1 HPV 13 TT Influenz_dult 14 Typhoid fever 1 1 Influenz_peditri 3 Typhoid-heptitis A 1 IPV 10 Vriell 6 JE 1 YF 1 JE_intd 1 1 dose presenttion inludes one-dose mpoules, vils or vine prefilled syringes.

17 MANUFACTURER BASE OF PROCURED VACCINES 9 Mnufturer se of proured vines A ompetitive supply environment represents n importnt driver to optimizing vine pries: s ompetition inreses nd supply is suffiient to meet demnd, pries n derese to sustinle plteu. Tle 5 lssifies vine produts into three groups limited, moderte or lrge sed on the numer of mnufturers of proured vines, s reported y prtiipting Memer Sttes. TABLE 5. Distriution of proured vine produts y numer of vine mnufturers Mnufturer se Limited Moderte Lrge (1 3 mnufturers) (3 4 mnufturers) ( 5 mnufturers) Vine No. of Vine No. of Vine No. of mnufturers mnufturers mnufturers HepAHepB 1 Influenz_dult 3 DTwP 5 HiMenC 1 Influenz_peditri 3 BCG 6 JE 1 IPV 3 TT 6 JE_intd 1 Mesles 3 DT 7 Men ACWY 1 MenC_onj 3 HepB_peditri 7 MMRV 1 PCV 3 Td 13 MR 1 TdP 3 TBE 1 Typhoid fever 3 Typhoid-heptitis A 1 DTwP-Hi-HepB 4 YF 1 HepB_dult 4 DTP 2 MMR 4 DTP-Hi 2 OPV 4 DTP-Hi-HepB-IPV 2 DTP-Hi-IPV 2 HepA 2 Hi 2 HPV 2 Pneumo_ps 2 Rotvirus 2 Tdp-IPV 2 Vriell 2 These dt do not represent the numer of glolly ville mnufturers, nor does it imply similr qulity stndrds for eh mnufturer reported. The numer of mnufturers ville to supply vines in eh Memer Stte my differ due to mrket uthoriztion nd ntionl regultory requirements. Furthermore, the mnufturers reported s hving supplied vines my not represent ll those ville in eh Memer Stte.

18 10 REVIEW OF VACCINE PRICE DATA More thn hlf of the proured vines (22) were only supplied y one or two mnufturers. Among these re new nd underused vines, suh s rotvirus, PCV, HPV, ellulr pertussis (P) nd IPV-sed vine omintions. A moderte mnufturer se ws reported for 12 produts, inluding ommonly used OPV, IPV, MMR nd DTwP-Hi-HepB vines. The list of vines with helthy ompetitive mnufturer se ws reltively short nd inluded trditionl vines. Key point Memer Sttes re enourged to review lol versus interntionl suppliers nd seek opportunities to optimize lolly ville ompetition. A restrited mnufturer se my limit the ility of Memer Sttes to otin n optimum vine prie nd my inrese the supply hin unertinty, oth in terms of gining ess to vine supply (i.e. willingness of the supplier to supply the produt to speifi mrket) nd gining uninterrupted supply of ontrted produts (i.e. in se of mnufturing or supply disruptions). The dt olletion tool did not provide the opportunity to review other ftors tht my disourge or limit the ompetition t the ountry level, suh s regultory requirements (i.e. mrket uthoriztion fee poliies, dossier review timing nd requirements, lol lnguge nd representtion requirements), progrmmti requirements (produt formultion nd presenttion, vine vil monitors), s well s prourement poliies nd ontrtul terms (i.e. long-term foresting, nnul versus multiyer ontrting, pyment mehnisms nd timelines, dditionl/undled servies, et.). Memer Sttes re enourged to review lol versus interntionl suppliers nd seek opportunities to optimize lolly ville ompetition. A vine mrket review needs to inform progrmmti deisions on dopting speifi produt formultions or presenttions to ensure ess to qulity produts t n ffordle prie. WHO provides system for the prequlifition of vines to determine the eptility, in priniple, of vines from different soures for supply to UNICEF nd other United Ntions genies tht purhse vines (11). The list of WHO prequlified vines nd their mnufturers s of 1 Jnury 2015 is in Appendix 6; the list is ontinuously updted (12). Furthermore, informtion regrding vines registered with the Europen Mediines Ageny n e found t its wesite (13).

19 REPORTED VACCINE PRICES 11 Reported vine pries Vine priing is omplex nd multidimensionl sujet. A numer of importnt demnd side (purhsing) ftors my influene the vine prie suh s prourement mehnism, sle of prourement, prourement methodology nd ontrtul terms (suh s pyment nd delivery terms). Sine ountries reported pries using different prourement prmeters nd dt were not ville or insuffiient to disggregte ording to these prmeters, the min purpose of this report is to show vrition of pries nd some of the ftors potentilly influening pries. Prie informtion tles per vine produt provide ountry-speifi prmeters olleted for eh proured vine (see Appendix 3). The tles re stndrdized. Vine prie dt were provided y individul ountries, nd pries re expressed in US dollrs (using the World Bnk s verge nnul exhnge rtes for 2013 (9)) nd rnked from minimum to mximum vlue. Individul prourement reords inlude some of the vriles expeted to hve potentil impt on prie, inluding the ountry inome group, volume of prourement, produt formultion nd presenttion, delivery terms nd vine prourement mehnism. Country nmes nd mnufturers re not inluded in this report, ssuming tht suh informtion should not represent n essentil priing driver. Where Memer Sttes reported prourement through UNICEF SD nd provided prie pid, this prie is reorded s reported nd my differ from pries reported y UNICEF SD (14). Quntittive prie estimtes were lso lulted. However, the quntittive mesures used do not ount for the heterogeneity of individul prourement ftors. In some instnes, this leds to underestimting or overestimting the vine pries. Therefore, the utilized quntittive mesures nd the susequent results should not e onsidered representtive ut rther illustrtive. Key point The utilized prie mesures im to illustrte prie vritions nd enourge more trnspreny to understnd the underlying uses. They should not e onsidered representtive or set ny prie enhmrks. Minimum nd mximum prie vlues for speifi produt define the oserved rnge of prie vrition. The verge mesures of prie in this nlysis inlude the medin prie nd the WAP. WAP represents the verge prie weighted y the volume of eh purhsed produt. WAP is sensitive, in prtiulr, to the prie pid for lrger volumes. The medin prie represents mid-rnge vine prie vlue ross reported prourements, is not dependent on extreme prie vlues nor on proured volumes, nd would represent etter the prie otined during n verge prourement regrdless of the proured volume. A lrge differene etween WAP nd the medin prie indites skewed distriution of the prie pid for vine produt, whih ould e used y multiple ftors. Dt interprettion would require, in ddition, detiled review of individul prourement ontext tht is eyond the sope of the dt olletion mehnism used in this report. Tle 6 summrizes the quntittive prie dt nd displys importnt prie vritions for most of the proured vine produts.

20 12 REVIEW OF VACCINE PRICE DATA TABLE 6. Minimum, mximum, medin nd verge pries reported y vine produt Vine prie per dose (US$) No. of Vines with rerported rerported prie dt prourements Minimum Mximum Medin WAP DT-IPV N/A N/A Influenz_peditri N/A N/A Men AC N/A N/A YF N/A N/A OPV DTwP BCG MR TT Td DT Mesles DTwP-Hi-HepB Rotvirus HepB_peditri Influenz_dult MMR IPV Typhoid fever DTP Hi HepB_dult TdP Pneumo_ps Men ACWY DTP-IPV DTP-Hi-IPV MenC_onj HepA HepAHepB Vriell HPV DTP-Hi DTP-Hi-HepB-IPV PCV Sorted y medin prie N/A: not pplile Generlly, new nd underused vines show signifintly higher verge pries nd prie vritions ompred to trditionl vines, suh s BCG, OPV, DTP nd MMR. Prourement ontext, progrmmti nd produt detils re essentil in understnding the nture of the vritions. For exmple, in the se of pneumool onjugte vines, two ountries enefit from susidized donor prie, whih is onsiderly lower thn the unsusidized pries. However, in the se of mny other vines (i.e. DTP-Hi-HepB-IPV, DTP-Hi-IPV) there re no susidy mehnisms tht would influene the prie vrition. A prtiulr hllenge is interpreting the prie of rotvirus vine, where oth prie susidy mehnisms (to ountries enefiting from GAVI support) nd different primry vintion shedules re pplied depending on the vine produt used (2 versus 3 doses per shedule). Furthermore, some vines, while preventing the sme diseses, my hve different ntigen formultions, i.e. pneumool onjugte vine (PCV10 versus PCV13) 1 nd HPV vine (qudrivlent versus ivlent vine). Prie informtion tles in Appendix 2 provide dditionl informtion to llow the reder to mke n informed omprison. 1 PCV 10 (or PCV 13) vlent inludes ntigens from the 10 (or 13) most ommon serotypes using invsive pneumool disese mong hildren.

21 REPORTED VACCINE PRICES 13 Country inome level nd vine pries pid Tiered priing is form of prie differentition: hrging different pries, in different mrkets, for the sme produt. Generlly, vine mnufturers dopt their own individul poliies to hrge higher vine pries in welthier ountries while keeping pries lower for ountries tht nnot fford the prie on the open mrket nd for donor supported prourement. Two produts re nlysed further: heptitis B vine widely implemented produt with lrge supplier se nd HPV vine, reltively new produt with limited supplier se. The dt olleted show tht high vine pries re exhiited not only in HICs ut lso in MICs. Fig. 2 2 show prie vritions of heptitis B (peditri dose) nd HPV vines ross ountries of different inome groups. Heptitis B vine is widely used produt, nd its prourement nd pries were reported y ountries of ll inome groups. In ontrst, HPV vine pries were reported only y HICs nd UMICs. The figures disply the medin vlue, the perentile (interqurtile) rnge, s well s minimum nd mximum prie vlues pid y Memer Sttes. FIG 2A. HepB peditri vine prie y ountry inome group FIG 2B. HPV vine prie y ountry inome group 14 VACCINE PRICE (US$) Mximum 100 VACCINE PRICE (US$) th perentile Medin 25th perentile 80 8 Minimum HICs UMICs LMICs LICs 0 HICs UMICs The reported dt show tiered priing for the heptitis B vine; the prie inrese follows the inome level of the Memer Sttes. The sitution is very different, however, in the se of the HPV vine, new nd underused vine. MICs pid onsiderly higher prie thn HICs. Why did MICs py higher prie for new nd initilly very expensive vine? This rises n importnt prie equity issue tht needs to e ddressed in the ontext of Key point Compred to HICs, UMICs pid higher prie for HPV vines, rising prie equity nd sustinility onerns.

22 14 REVIEW OF VACCINE PRICE DATA rehing EVAP ojetives. The ost effiieny of introduing new vines is key onern, nd unsustinl high vine pries my prevent Memer Sttes from deiding to introdue new vines. High vrition of vine pries within inome groups is oserved for oth vines, whih indites potentil opportunities to improve prourement effiieny. Vine prourement volumes nd prie Did the prourement of lrger vine volumes result in lower pries? In generl, the lrger the volumes of proured vine, the lower the pries were. This trend is vlid for oth the proured HepB_peditri nd HPV vines, lthough importnt prie vritions for the sme proured volumes re seen s well. Fig. 3 3 depit the pries pid y Memer Sttes per purhsed volume. FIG 3A. HepB peditri vine prie/dose y proured volume nd ountry inome group FIG 3B. HPV prie/dose y proured volume nd ountry inome group 12 VACCINE PRICE (US$) VACCINE PRICE (US$) HICs UMICs LMICs LICs HICs UMICs PROCURED VOLUME (DOSES) PROCURED VOLUME (DOSES) As expeted, LICs nd LMICs pid the lowest prie per volume for HepB_peditri vines. All ut one UMIC fit in the prie/volume trend s well. HICs pid the highest heptitis B vine pries, following the trend of deresing prie per purhsed volume. By ompring similr proured volumes, Fig. 3 shows tht ll three HPV prie points reported y UMICs re higher thn pries reported for HICs. Understnding why UMICs ould not hieve t lest the sme or lower prie per volume ompred to HICs nd ddressing prourement ineffiienies re key to mking the new vines more ffordle nd equitle. Key point Compred to HICs, UMICs ould not hieve t lest the sme or lower prie per volume in prouring HPV vines.

23 REPORTED VACCINE PRICES 15 Vine presenttion nd prie Vine presenttion is nother importnt prie driver. In generl, pries per dose re lower with the inresing presenttion size of produt. The pries of two produts ville in vrious presenttions (HepB nd MMR) re nlysed further. Fig. 4 4 show tht for oth HepB nd MMR vines, the prie of 10 dose presenttions re lower thn 1- or 2-dose presenttions. However, 10-dose presenttions were proured only y LICs nd LMICs; UMICs proured 1- nd 2-dose presenttions, nd HICs proured exlusively single-dose presenttions. Fig. 4 4 show, in numer of situtions, tht UMICs pid higher prie per dose for the sme vine presenttion ompred to some HICs. Both HepB nd MMR vines hve high vrition of vine prie within the sme presenttion. FIG 4A. HepB_peditri vine prie/dose y vine presenttion nd ountry inome group FIG 4B. MMR prie/dose y vine presenttion nd ountry inome group VACCINE PRICE (US$) VACCINE PRICE (US$) dose/vil 2 doses/vil 10 doses/vil dose/vil 2 doses/vil 10 doses/vil HICs UMICs LMICs LICs HICs UMICs LMICs LICs Key point Compred to HICs, UMICs fvor single dose presenttions nd often pid higher vine prie for the sme presenttion. Vine formultion nd prie Pries vry y produt formultion s well; for exmple, P-ontining vines ontinue to e signifintly more expensive thn whole-ell pertussis (wp) ontining produts. Aording to WHO, oth P-ontining nd wp-ontining vines hve exellent sfety reords. The mrginl enefit of hnging from wp-ontining to P-ontining vines should therefore e refully weighed ginst the issue of ffordility (15). The limited supplier se in P-ontining vines, ompred to the moderte or lrge supplier ses for wp-ontining produts (Tle 5), would lso dvntge wp-ontining vines in terms of gining prourement effiienies nd seuring n uninterrupted supply.

24 16 REVIEW OF VACCINE PRICE DATA Tle 7 shows tht prourement of P- nd wp-ontining vines vry y inome group; the higher the inome group, the higher the shre of proured P-ontining vines. In prtiulr, LICs reported prouring exlusively wp formultions; LMICs reported P formultions in two out of 11 prourements; UMICs reported lrger shre of P-ontining vines (10 out of 16 proured produts); nd HICs reported prourement of P-ontining vines in ll ut one se. TABLE 7. Frequeny of proured formultions of pertussis-ontining vines y ountry inome group Vine HICs UMICs LMICs LICs TOTAL DTP DTP-Hi 2 2 DTP-Hi-HepB-IPV DTP-Hi-IPV DTP-IPV DTwP DTwP-Hi-HepB Totl P-ontining vines Totl wp-ontining vines Equivlent P nd wp produts were reported for one type of omined vine DTP. Other reported vine omintions vry y their ntigens. Fig. 5 5 ompre pries for two types of produts; one ontins three ntigens (DTwP versus DTP) nd the other ontins five ntigens (DTwP-Hi-HepB versus DTP-Hi-IPV). Fig. 5 shows tht DTwP pries were low with little vrition, with the exeption of the prie pid y one HIC for domesti wp produt. For DTP, pries were signifintly higher nd showed lrge vrition. The prie pid y LMICs nd UMICs for DTP rehed the level pid y HICs. FIG 5A. DTwP nd DTp vine prie y ountry inome group FIG 5B. DTwP Hi HepB nd DTP Hi IPV vine prie y ountry inome group VACCINE PRICE (US$) VACCINE PRICE (US$) 25 DTwP DTP DTwP-Hi-HepB DTP-Hi-IPV HICs UMICs LMICs LICs HICs UMICs LMIs LICs

25 REPORTED VACCINE PRICES 17 A similr pttern is oserved for pentvlent vine omintions in Fig 5. DTwP-Hi-HepB ws introdued in LMICs with GAVI support nd ws proured minly through UNICEF SD. Vine pries were low, with little vrition, refleting minly the use of different vine presenttions rther thn inome group differenes. DTP-Hi-IPV pries were onsiderly higher, with lrge vritions oth etween nd within inome groups. UMICs pid generlly lower pries; however, in numer of ses, the pries rehed or surpssed those pid y some HICs. Key point Pries of vine formultions vry. The ost implitions of speifi formultion hoie need to e refully onsidered ginst ttined enefits. It should e noted tht P produt omintions my ring omprtive dvntge y providing roder rnge of ntigens in one produt, inluding IPV, whih is not ville in wp-ontining vines. These gin importne in the ontext of the Polio Erdition nd Endgme Strtegi Pln (16), whih reommends introdution of t lest one dose of IPV into routine immuniztion shedules (17). It is eqully true, however, tht stndlone IPV produts re ville t muh lower pries nd ould e dministered onomitntly with wp-omined produts. The GAVI Alline s deision to support the introdution of stndlone IPV in GAVI-eligile nd grduting ountries ould represent ost-effiient exmple of produt formultion hoie (18).

26 18 REVIEW OF VACCINE PRICE DATA WHO s V3P pltform WHO estlished the V3P pltform to ollet detiled nd omprehensive vine prie informtion from ountries nd mke it pulily ville (3). In doing so, V3P prtiiptes in glol reporting on vine pries to further prtners efforts on improving prie trnspreny nd to inform ontinued disussion on ffordle priing. The informtion olleted y V3P is used to monitor glol prie nd prie trnspreny trends for the GVAP vine prie report tht is prt of the GVAP monitoring. (4). The V3P pltform is one-stop-shop wesite tht inludes: prie dtse olleting nd disseminting dt on vine pries nd key prourement ftors; repository of V3P-speifi doumenttion, nlyses s well s key reports nd updtes; nd gtewy with links to other vine nd immuniztion relted soures. Memer Sttes re enourged to shre nd enefit from more detiled informtion y essing the V3P dtse diretly (19). A ntionl fol point to shre priing informtion shll e nominted in dvne nd detils ommunited to WHO in order to grnt ess to the input tool of the V3P dtse. Alterntively, ountries n lso hoose to shre their vine prie dt through their JRF. Key point WHO s V3P pltform ollets detiled nd omprehensive vine prie informtion from ountries nd mkes it pulily ville through its online dtse. Appendix 7 provides dditionl soures for pulished vine priing dt, whih n e essed through the V3P resoure gtewy (20).

27

28 20 REVIEW OF VACCINE PRICE DATA Referenes 2 1. The right shot: ringing down rriers to ffordle nd dpted vines, 2nd edition. Genev: Médeins Sns Frontières; 2015 ( 2. Mking vines more ffordle. In: GAVI The Vine Alline [wesite]. Genev: GAVI Alline; 2015 ( 3. The Vine Produt, Prie nd Prourement (V3P) Projet. In: World Helth Orgniztion [wesite]. Genev: World Helth Orgniztion; 2015 ( 4. Glol Vine Ation Pln Genev: World Helth Orgniztion; 2013 ( 5. World Helth Assemly resolution WHA Glol vine tion pln. Sixty-fifth World Helth Assemly, Genev, My Genev: World Helth Orgniztion; 2012 ( 6. Glol vine tion pln. Report y the Seretrit, 22 Mrh Provisionl gend item 16.1 to Sixty-sixth World Helth Assemly, Genev, My Genev: World Helth Orgniztion; 2013 ( 7. Meeting of the Strtegi Advisory Group of Experts on immuniztion, Otoer 2014 onlusions ndreommendtions. Wkly Epidemiol Re. 2014;50(89): ( who.int/wer/2014/wer8950.pdf?u=1). 8. Europen Vine Ation Pln Copenhgen: WHO Regionl Offie for Europe; 2014 ( 9. Offiil exhnge rte (LCU per US$, period verge) [online dtset]. Wshington, DC: World Bnk; 2015 ( pge=30000∓dte=2005:2013). 10. Gross ntionl inome per pit 2012, Atls method nd PPP. Wshington, DC: World Bnk; 2013 ( essed 23 Septemer 2013). 11. A system for the prequlifition of vines for UN supply. In: World Helth Orgniztion [wesite]. Genev: World Helth Orgniztion; 2015 ( stndrds/vine_qulity/pq_system/en/). 12. WHO prequlified vines [online dtset]. Genev: World Helth Orgniztion; 2015 ( 13. Europen Mediines Ageny [wesite]. London: Europen Mediines Ageny; 2015 ( Vine prie dt. In: UNICEF [wesite]. Copenhgen: United Ntions Children s Fund; 2015 ( 2 Wesites essed 3 Mrh 2015 unless noted otherwise.

29 REFERENCES Revised guidne on the hoie of pertussis vines: July Wkly Epidemiol Re. 2014;30(89): ( 16. Polio Erdition nd Endgme Strtegi Pln Genev: World Helth Orgniztion; 2013 ( spx). 17. Polio vines: WHO position pper, Jnury Wkly Epidemiol Re. 2014;9(89):73 92 ( 18. Intivted polio vine support. In: GAVI The Vine Alline [wesite]. Genev: GAVI Alline; 2015 ( 19. V3P we pltform. Prie dtse [online dtse]. Genev: World Helth Orgniztion; 2015 ( 20. Resoure gtewy V3P. In: World Helth Orgniztion [wesite]. Genev: World Helth Orgniztion; 2015 (

30

31 APPENDIX 1 23 Appendix 1. JRF templte used to ollet vine priing dt for B1. Is informtion on pries of vines, proured for the ntionl immuniztion progrmme, ville t the ntionl level in your ountry? If no, plese explin why vine prie Informtion is not ville t the ntionl level. 2B2. Is informtion on pries of vines, proured for the ntionl immuniztion progrmme, pulished on puli domin in your ountry? If yes, plese indite the domin where ntionl vine prie informtion n e essed. 2B3. Are there legl provisions restriting shring informtion on pries of vine, proured for the ntionl immuniztion progrmme, in your ountry? If yes, plese provide detils on provisions tht do restrit shring vine prie informtion. A B C D E F G H I J K L Vine/ Supplies Vil size (doses per vil) Nme of mnufturer Country of mnufture Whih Totl no. geny of proured proured doses the vine (units for syringes nd sfety oxes) Curreny Contrted or quoted terms of delivery Totl ost pid ording to quoted Inoterm FCA prie per dose (FCA ost/no. of doses) DDP prie per dose (DDP ost/no. of doses) Notes

32 24 REVIEW OF VACCINE PRICE DATA Appendix 2. Memer Sttes reporting sttus of vine priing dt in the nnul WHO/UNICEF JRF, 2013 TABLE A2.1. Reporting sttus Country Reporting sttus Country Reporting sttus Alni Complete Lithuni Inomplete Andorr Complete Luxemourg Not reported Armeni Complete Mlt Not reported Austri Missing JRF Mono Missing JRF Azerijn Not reported Montenegro Not reported Belrus Inomplete Netherlnds Complete Belgium Not reported Norwy Inomplete Bosni nd Herzegovin Missing JRF Polnd Complete Bulgri Not reported Portugl Complete Croti Complete Repuli of Moldov Complete Cyprus Not reported Romni Complete Czeh Repuli Not reported Russin Federtion Not reported Denmrk Not reported Sn Mrino Complete Estoni Complete Seri Not reported Finlnd Complete Slovki Complete Frne Not reported Sloveni Complete Georgi Inomplete Spin Complete Germny Not reported Sweden Not reported Greee Not reported Switzerlnd Not reported Hungry Not reported Tjikistn Complete Ielnd Complete The former Yugoslv Repuli of Medoni Complete Irelnd Missing JRF Turkey Complete Isrel Inomplete Turkmenistn Inomplete Itly Missing JRF Ukrine Missing JRF Kzkhstn Complete United Kingdom Not reported Kyrgyzstn Complete Uzekistn Complete Ltvi Complete Inomplete indites return of the JRF form with prtil dt filled out. Missing JRF indites tht no JRF form ws sumitted y the ountry. Not reported indites tht the JRF form ws returned with empty vine prie templte. For more detils plese see the setion on reporting of vine prie dt.

33 APPENDIX 3 25 Appendix 3. Country-speifi vine prie dt y individul produt Prie informtion tles (Tles A3.1 A3.35) provide ountry-speifi prmeters olleted for eh proured vine. The detils re in the hpter Reported vine pries. Vine pries re expressed in US dollrs using the World Bnk s verge nnul exhnge rtes for 2013 (1) nd ountry inome groups re sed on gross ntionl inome (GNI) per pit dt from the World Bnk (2). Where Memer Sttes reported prourement through UNICEF SD nd provided prie pid, this prie is reorded s reported nd my differ from pries reported y UNICEF SD (3). The ppendix tles use the following suset of Inoterms 2010, set of rules pulished y the Interntionl Chmer of Commere, whih define the responsiilities of sellers nd uyers for the delivery of goods under sles ontrts (4): ost insurne nd freight (CIF) rrige nd insurne pid to (CIP) delivered t ple (DAP) delivered duty pid (DDP) ex works (EXW) free rrier (FCA).

34 26 REVIEW OF VACCINE PRICE DATA TABLE A3.1. BCG No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 20 UNICEF SD CIF 0.06 Inludes 10% vlue-dded tx(vat) & 3% exise tx 2 LMIC 20 UNICEF SD CIF LMIC 20 UNICEF SD FCA LIC 20 UNICEF SD FCA LMIC 20 UNICEF SD CIF 0.14 Inludes 10% VAT & 3% exise tx 6 LIC 20 UNICEF, FCA 0.14 WHO or PAHO 7 LMIC 20 Government geny DDP UMIC 10 Government geny DDP HIC 10 Government geny FCA UMIC 20 Government geny DDP HIC 20 Government geny N/D DDP UMIC 10 Government geny DDP HIC 10 N/D CIP HIC 10 Government geny DDP HIC 10 Government geny DDP 1.39 DDP servie points 16 UMIC 20 Government geny N/D HIC 10 Government geny N/A 4.58 In-ountry prodution 18 HIC 10 Government geny DDP Medin 0.39 WAP 0.29 N/A: not pplile; N/D: no dt or informtion ville; PAHO: Pn Amerin Helth Orgniztion. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.2. dt No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD CIF 0.11 Inludes 10% VAT & 3% exise tx 2 LIC 10 UNICEF SD FCA LIC 10 Government geny FCA LMIC 10 Government geny DDP UMIC 10 Government geny DDP HIC 1 Government geny 200 DDP 3.15 DDP servie points 7 UMIC 1 Government geny DDP HIC N/D Government geny 250 EXW HIC 10 Government geny 800 FCA HIC 1 Government geny N/A In-ountry prodution Medin 1.81 WAP 0.36 N/A: not pplile; N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

35 APPENDIX 3 27 TABLE A3.3. DTP No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny CIF LMIC 1 UNICEF SD CIF LMIC 1 UNICEF SD CIF HIC 1 Government geny N/D DDP UMIC 1 Government geny DDP HIC N/D Government geny 20 EXW HIC 1 Government geny 900 N/D Entry tx free Medin 9.15 WAP 5.58 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.4. DTP-Hi No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny DDP HIC N/D Government geny 10 EXW Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.5. DTP-Hi-HepB-IPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny N/D UMIC 1 N/D DDP UMIC 1 Government geny N/D HIC N/D Government geny FCA Tx free, 2-yer prourement 5 HIC 1 Government geny DDP DDP servie points 6 HIC 1 Government geny DDP HIC 1 Government geny DAP Phrmy prie 8 HIC 1 Government geny N/D Entry tx free 9 HIC N/D Government geny 800 EXW Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

36 28 REVIEW OF VACCINE PRICE DATA TABLE A3.6. DTP-Hi-IPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP UMIC 1 Government geny DDP HIC 1 Government geny N/D HIC 1 N/D DAP HIC 1 Government geny N/D DDP UMIC 1 Government geny N/D HIC 1 Government geny DDP HIC 1 Government geny FCA HIC 1 Government geny DDP HIC N/D Government geny FCA Tx free, 2-yer prourement 11 HIC 1 Government geny 459 DDP DDP servie points 12 HIC 1 Government geny N/D Entry tx free Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.7. DTP-IPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 Government geny FCA HIC 1 Government geny DDP HIC 1 Government geny N/D HIC N/D Government geny 400 EXW HIC 1 Government geny DAP Phrmy prie 9 HIC 1 Government geny DDP DDP servie points Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue TABLE A3.8. DT-IPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny DDP 8.10 Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue

37 APPENDIX 3 29 TABLE A3.9. DTwP No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD CIF 0.10 Inludes 10% VAT & 3% exise tx 2 LIC 10 UNICEF SD FCA LMIC 10 UNICEF SD FCA LIC 10 UNICEF SD FCA LMIC 10 Government geny DDP UMIC 10 Government geny DDP LMIC 1 Government geny DDP HIC 1 Government geny N/A 3.08 Medin 0.38 WAP 1.03 N/A: not pplile. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.10. DTwP-Hi-HepB No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD N/D 2.14 GAVI prie 2 LIC 1 UNICEF SD FCA 2.40 GAVI prie 3 LIC 1 UNICEF SD FCA 2.61 GAVI prie 4 LMIC 1 UNICEF SD CIF 2.70 Inludes 10% VAT & 3% exise tx 5 LIC 1 UNICEF SD FCA 2.70 GAVI prie 6 LIC 1 UNICEF SD FCA 2.70 GAVI prie 7 LIC 1 UNICEF SD FCA 2.70 GAVI prie 8 LIC 1 UNICEF SD FCA 2.70 GAVI prie 9 LMIC 1 UNICEF SD CIP 2.79 GAVI prie 10 LMIC 1 UNICEF SD CIP 2.79 GAVI prie 11 LMIC 2 UNICEF SD CIF 2.95 GAVI prie Medin 2.70 WAP 2.39 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

38 30 REVIEW OF VACCINE PRICE DATA TABLE A3.11. HepA No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP HIC N/D Government geny FCA Tx free, 2-yer prourement 3 HIC 1 Government geny 104 DDP HIC 1 N/D 91 DAP HIC N/D Government geny 50 EXW HIC 1 Government geny 388 DDP Medin WAP 7.91 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.12. HepAHepB No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny 288 DDP Peditri 2 HIC 1 Government geny DDP Adult 3 HIC 1 N/D 370 DAP Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.13. HepB_dult No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 N/D DAP HIC N/D Government geny FCA Tx free, 2-yer prourement 5 HIC 1 Government geny DDP HIC 1 Government geny 150 N/D Entry tx free 7 HIC N/D Government geny 50 EXW HIC 1 Government geny 428 DDP DDP servie points Medin WAP 7.19 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

39 APPENDIX 3 31 TABLE A3.14. HepB_peditri No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD FCA LIC 1 UNICEF SD FCA LMIC 1 UNICEF SD CIF 0.38 Inludes 10% VAT 4 LMIC 1 UNICEF SD CIF LIC 1 UNICEF SD FCA UMIC 2 Government geny DDP LMIC 1 Government geny DDP UMIC 1 Government geny DDP UMIC 1 Government geny N/D HIC 1 Government geny N/A 2.19 & 3% exise tx 11 HIC 1 Government geny DDP 3.41 DDP servie points 12 HIC 1 Government geny FCA UMIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 N/D DAP HIC N/D Government geny FCA 6.51 Tx free, 17 HIC 1 Government geny N/D DDP yer prourement 18 HIC 1 Government geny N/D 7.04 Entry tx free 19 HIC 1 Government geny N/D 7.70 Entry tx free 20 HIC 1 Government geny DDP HIC N/D Government geny 20 EXW Medin 3.41 WAP 1.48 N/A: not pplile; N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.15. Hi No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP HIC 1 Government geny CIF HIC 1 N/D 395 DAP HIC N/D Government geny FCA Tx free, 2-yer prourement 5 HIC N/D Government geny 10 EXW HIC 1 Government geny 150 DDP Medin 9.42 WAP 6.55 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

40 32 REVIEW OF VACCINE PRICE DATA TABLE A3.16. HPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 Government geny N/D HIC 1 Government geny DDP DDP servie points 5 HIC 1 Government geny DDP HIC N/D Government geny FCA Tx free, 7 HIC 1 N/D DAP UMIC 1 Government geny DDP UMIC 1 Government geny DDP HIC N/D Government geny 50 EXW UMIC 1 Government geny DDP Medin WAP yer prourement N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.17. Influenz_dult No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP HIC 1 N/D CIP HIC 1 Government geny DDP HIC 1 Government geny DDP UMIC 1 Government geny DDP HIC N/D Government geny EXW LMIC PFS Government geny DDP HIC 1 Government geny DDP HIC 1 Other N/D LMIC 1 Other N/D Medin 4.62 WAP 4.55 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.18. Influenz_peditri No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 N/D 350 CIP 5.46 N/A: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

41 APPENDIX 3 33 TABLE A3.19. IPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny N/D DDP HIC 1 Government geny CIF UMIC 1 Government geny N/D HIC 1 Government geny FCA HIC 1 N/D 255 DAP HIC N/D Government geny 20 EXW HIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 Government geny 24 DDP DDP servie points Medin 7.21 WAP 6.32 N/D: no dt or informtion ville. TABLE A3.20. Mesles No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP UMIC 2 Government geny DDP HIC 1 N/D 300 CIP 5.98 Medin 2.09 WAP 1.80 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

42 34 REVIEW OF VACCINE PRICE DATA TABLE A3.21. MMR No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LIC 10 UNICEF SD FCA LMIC 10 UNICEF SD FCA LMIC 10 Government geny DDP LMIC 1 Government geny DDP LMIC 2 UNICEF SD CIF 3.25 Inludes 10% VAT & 3% exise tx 6 LMIC 2 UNICEF SD CIF LMIC 2 UNICEF SD CIF LMIC 2 UNICEF SD CIF UMIC 1 Government geny DDP UMIC 1 Government geny DDP HIC 1 N/D DAP HIC 1 Government geny N/D DDP HIC 1 Government geny FCA HIC 1 Government geny DDP HIC 1 Government geny CIF UMIC 1 Government geny DDP UMIC 1 Government geny N/D HIC 1 Government geny DDP 7.63 DDP servie points 19 HIC N/D Government geny FCA 7.76 Tx free, 2-yer prourement 20 HIC 1 Government geny DDP HIC 1 Government geny N/D 9.16 Entry tx free 22 HIC 1 Government geny DDP HIC 1 Government geny 333 DAP Phrmy prie 24 HIC 1 Government geny DAP Phrmy prie 25 HIC 1 Government geny N/D HIC N/D Government geny 600 EXW Medin 6.56 WAP 5.06 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.22. MR No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LIC 10 UNICEF SD FCA 0.52 LIC 2 LIC 10 Government geny FCA 0.60 LIC Medin 0.56 WAP 0.58 Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

43 APPENDIX 3 35 TABLE A3.23. Men AC No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 Other 950 FCA Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.24. Men ACWY No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC N/D Government geny 10 EXW HIC 1 N/D 200 DAP HIC N/D Government geny FCA Tx free, 2-yer prourement Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.25. MenC_onj No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC 1 Government geny DDP HIC 1 Government geny DDP HIC N/D Government geny FCA Tx free, 2-yer prourement 4 HIC 1 Government geny N/D HIC 1 Government geny N/D Entry tx free Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

44 36 REVIEW OF VACCINE PRICE DATA TABLE A3.26. OPV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 20 UNICEF SD FCA LMIC 10 UNICEF SD CIF 0.17 Inludes 10% VAT & 3% exise tx 3 LMIC 10 UNICEF SD CIF 0.18 Inludes 10% VAT & 3% exise tx 4 LMIC 10 UNICEF SD CIF LIC 10 UNICEF SD FCA LIC 10 UNICEF SD FCA UMIC 10 Government geny DDP UMIC 20 Government geny DDP UMIC 10,20 Government geny DDP LMIC 10 Government geny DDP UMIC 10 Government geny DAP HIC 10 Government geny CIF 7.67 Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. Medin 0.22 WAP 0.26 TABLE A3.27. Pneumo_ps No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC N/D Government geny FCA Tx free, 2-yer prourement 2 HIC 1 N/D CIP HIC N/D Government geny 80 EXW Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

45 APPENDIX 3 37 TABLE A3.28. PCV No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 1 UNICEF SD CIP 3.53 GAVI prie 2 LMIC 1 UNICEF SD CIP 3.99 GAVI prie 3 LMIC 1 UNICEF SD CIF Inludes 10% VAT 4 HIC 1 Government geny DDP HIC 1 Government geny DDP UMIC 1 Government geny CIP & 3% exise tx 7 HIC 1 Government geny DAP Phrmy prie 8 HIC 1 N/D 220 DAP HIC 1 Government geny DDP DDP servie points 10 HIC 1 Government geny CIF HIC 1 Government geny N/D HIC 1 Government geny DAP Phrmy prie 13 HIC 1 N/D DAP HIC N/D Government geny 90 EXW HIC 1 Government geny N/D Entry tx free Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.29. Rotvirus No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 1 UNICEF SD CIP 2.46 GAVI prie, 2 dose shedule 2 LMIC 1 UNICEF SD CIF 2.50 GAVI prie, 2 dose shedule 3 LMIC 1 UNICEF SD CIF 2.50 GAVI prie, 2 dose shedule 4 LMIC 1 UNICEF SD CIP 2.96 GAVI prie, 2 dose shedule 5 HIC 1 Government geny FCA dose shedule 6 HIC 1 Government geny DDP dose shedule Medin 2.73 WAP 9.80 Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

46 38 REVIEW OF VACCINE PRICE DATA TABLE A3.30. Td No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD CIF 0.10 Inludes 10% VAT & 3% exise tx 2 LMIC 10 UNICEF SD FCA LMIC 10 UNICEF SD CIF 0.11 Inludes 10% VAT & 3% exise tx 4 LMIC 10 UNICEF SD CIF LIC 10 UNICEF SD FCA UMIC 2 Government geny DDP LMIC 10 Government geny DDP UMIC 10 Government geny DDP HIC N/D Government geny N/D DDP HIC 1 Government geny N/A UMIC 1 Government geny DDP HIC 1 Government geny DDP HIC 1 N/D CIP UMIC 10 Government geny N/D HIC 1 Government geny DDP HIC N/D Government geny FCA 5.86 Tx free, 2-yer prourement 17 HIC 1 Government geny FCA HIC 1 Government geny DDP 8.90 DDP servie points 19 LIC 1 Donor geny FCA LIC 1 Donor geny FCA Medin 1.57 WAP 4.34 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.31. TdP No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC N/D Government geny 786,512 FCA Tx free, 2-yer prourement 2 HIC 1 Government geny 137,960 DDP HIC 1 N/D 18,000 DAP HIC 1 Government geny 6,496 N/D HIC 1 Government geny 25,000 FCA HIC 1 Government geny 800 N/D Entry tx free 7 HIC N/D Government geny 10 EXW HIC 1 Government geny 52,847 DAP Phrmy prie Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

47 APPENDIX 3 39 TABLE A3.32. TT No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 LMIC 10 UNICEF SD CIF 0.08 Inludes 10% VAT & 3% exise tx 2 UMIC 10 Government geny DAP HIC 10 Government geny N/D DDP HIC 1 Government geny N/A LMIC 2 Other N/D HIC N/D Government geny EXW HIC 1 N/D CIP 4.02 Medin 0.61 WAP 0.83 N/A: not pplile; N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.33. Typhoid fever No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 5 Government geny DDP HIC N/D Government geny 50 EXW Medin 9.05 WAP 4.24 N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. TABLE A3.34. Vriell No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 UMIC 1 Government geny DDP HIC 1 Government geny DDP DDP servie points 3 HIC 1 N/D 30 DAP HIC 1 Government geny CIF HIC N/D Government geny FCA Tx free, 2-yer prourement Medin WAP N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue.

48 40 REVIEW OF VACCINE PRICE DATA TABLE A3.35. YF No. Country Vil size Ageny Totl no. Contrted Contrted group vil) the vine doses delivery (US$) 1 HIC N/D Government geny FCA Tx free, 2-yer prourement N/D: no dt or informtion ville. Bsed on 2012 GNI per pit dt from the World Bnk (2). Bsed on Inoterms 2010 (4). Estimted using World Bnk ntionl urreny exhnge rtes for 2013 (1) nd sorted y vlue. Referenes 1. Offiil exhnge rte (LCU per US$, period verge) [online dtset]. The World Bnk. Wshington (DC): World Bnk; 2015 ( DPANUSLCU?per_pge=30000∓dte=2005:2013, essed 3 Mrh 2015). 2. Gross ntionl inome per pit 2012, Atls method nd PPP. Wshington (DC): World Development Inditors dtse, World Bnk, 17 Deemer 2013; ( org/inditor/ny.gnp.pcap.cd/ountries?disply=defult, essed 10 April 2015). 3. GNI per pit, Atls method (urrent US$), World Development Inditors dtse, World Bnk, 17 Deemer 2013; ( ountries?disply=defult, essed 10 April 2015) 4. Vine prie dt. In: UNICEF [wesite]. Copenhgen: United Ntions Children s Fund; 2015 ( essed 3 Mrh 2015). 5. Inoterms 2010 English Edition. Pris: ICC Servies/Pulitions; 2010 ( essed 3 Mrh 2015).

49 APPENDIX 4 41 Appendix 4. Ntionl urreny exhnge rtes to US dollrs TABLE A4.1. Curreny exhnge rtes Country Ntionl urreny unit (US$) Alni Andorr Armeni Austri Azerijn Belrus Belgium Bosni nd Herzegovin Bulgri Croti Cyprus Czeh Repuli Denmrk Estoni Finlnd Frne Georgi Germny Greee Hungry Ielnd Irelnd Isrel Itly Kzkhstn Kyrgyzstn Ltvi Lithuni Luxemourg Mlt Mono Montenegro Netherlnds Norwy Polnd Portugl Repuli of Moldov Romni

50 42 REVIEW OF VACCINE PRICE DATA TABLE A4.1. ontd Country Ntionl urreny unit (US$) Russin Federtion Sn Mrino Seri Slovki Sloveni Spin Sweden Switzerlnd Tjikistn The former Yugoslv Repuli of Medoni Turkey Turkmenistn Ukrine United Kingdom Uzekistn Soure: Offiil exhnge rte (LCU per US$, period verge) [online dtset]. Wshington (DC): World Bnk; 2015 (

51 APPENDIX 5 43 Appendix 5. Clssifition of Memer Sttes y ountry inome group TABLE A5.1. Clssifition of ountries Country GNI per pit (US$) Inome group Alni 4030 LMIC Andorr N/D HIC Armeni 3720 LMIC Austri HIC Azerijn 6220 UMIC Belrus 6530 UMIC Belgium HIC Bosni nd Herzegovin 4750 UMIC Bulgri 6840 UMIC Croti HIC Cyprus HIC Czeh Repuli HIC Denmrk HIC Estoni HIC Finlnd HIC Frne HIC Georgi 3270 LMIC Germny HIC Greee HIC Hungry UMIC Ielnd HIC Irelnd HIC Isrel HIC Itly HIC Kzkhstn 9780 UMIC Kyrgyzstn 990 LIC Ltvi HIC Lithuni HIC Luxemourg HIC Mlt HIC Mono N/D HIC Montenegro 7220 UMIC Netherlnds HIC Norwy HIC Polnd HIC Portugl HIC Repuli of Moldov 2070 LMIC Romni 8820 UMIC

52 44 REVIEW OF VACCINE PRICE DATA TABLE A5.1. ontd Country GNI per pit (US$) Inome group Russin Federtion HIC Sn Mrino N/D HIC Seri 5280 UMIC Slovk Repuli HIC Sloveni HIC Spin HIC Sweden HIC Switzerlnd HIC Tjikistn 860 LIC The former Yugoslv Repuli of Medoni 4620 UMIC Turkey UMIC Turkmenistn 5410 UMIC Ukrine 3500 LMIC United Kingdom HIC Uzekistn 1720 LMIC LIC: low-inome ountry (GNI = US$ 1035 or less) LMIC: lower-middle-inome ountry (GNI = US$ ) UMIC: upper-middle-inome ountry (GNI = US$ ) HIC: high-inome ountry (GNI = US$ or more) N/D - No GNI per pit dt ville. Estimted to e high inome. Soure: GNI per pit, Atls method (urrent US$), World Development Inditors dtse, World Bnk, 17 Deemer 2013; ( essed 10 April 2015).

53 APPENDIX 6 45 Appendix 6. List of WHO prequlified vines s of 1 Jnury TABLE A6.1. WHO prequlified vines Doses/ primry Vine Mnufturer nme Presenttion ontiner BCG Jpn BCG Lortory Ampoule 20 Ntionl Center of Infetious nd Prsiti Diseses Ampoule 10 Ntionl Center of Infetious nd Prsiti Diseses Ampoule 20 Serum Institute of Indi Limited Vil 20 Sttens Serum Institut Two vil set (tive + exipient) 10 Choler: intivted orl Cruell Sweden AB Vil + Buffer Shet 1 Shnth Biotehnis Limited Vil 1 Diphtheri tetnus Bio Frm Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 20 Snofi Psteur SA Vil 10 Snofi Psteur SA Vil 20 Serum Institute of Indi Limited Ampoule 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Diphtheri tetnus (for dults) Bio Frm Vil 10 Biologil E. Limited Vil 1 Biologil E. Limited Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 20 Snofi Psteur SA Vil 10 Serum Institute of Indi Limited Ampoule 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Diphtheri tetnus pertussis (whole ell) Bio Frm Vil 10 Biologil E. Limited Vil 1 Biologil E. Limited Vil 10 Snofi Psteur SA Ampoule 1 Snofi Psteur SA Vil 10 Snofi Psteur SA Vil 20 Serum Institute of Indi Limited Ampoule 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 1 WHO prequlified vines [online dtset]. Genev: World Helth Orgniztion; 2015 ( essed 25 Ferury 2015).

54 46 REVIEW OF VACCINE PRICE DATA TABLE A6.1. ontd Doses/ primry Vine Mnufturer nme Presenttion ontiner Diphtheri tetnus pertussis (whole Novrtis Vines & Dignostis Srl Vil 1 ell) Hemophilus influenze type Novrtis Vines & Dignostis Srl Vil 10 Snofi Psteur SA Two vil set (tive + tive) 10 Snofi Psteur SA Vil + Ampoule 1 Serum Institute of Indi Limited Two vil set (tive + tive) 1 Diphtheri tetnus pertussis Bio Frm Vil 5 (whole ell) heptitis B Bio Frm Vil 10 GlxoSmithKline Biologils SA Vil 1 GlxoSmithKline Biologils SA Vil 2 GlxoSmithKline Biologils SA Vil 10 Serum Institute of Indi Limited Ampoule 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Diphtheri tetnus pertussis (whole ell) Bern Bioteh Kore Corp. Vil 1 heptitis B Hemophilus influenze type Bern Bioteh Kore Corp. Compt Prefilled Auto-disle Devie 1 Bio Frm Vil 5 Bio Frm Vil 10 Biologil E. Limited Two vil set (tive + tive) 1 Biologil E. Limited Two vil set (tive + tive) 10 Biologil E. Limited Vil 1 Biologil E. Limited Vil 10 GlxoSmithKline Biologils SA Two vil set (tive + tive) 1 GlxoSmithKline Biologils SA Two vil set (tive + tive) 2 LG Life Sienes Vil 1 LG Life Sienes Vil 2 Pne Biote Vil 1 Pne Biote Vil 10 Serum Institute of Indi Limited Two vil set (tive + tive) 1 Serum Institute of Indi Limited Two vil set (tive + tive) 2 Serum Institute of Indi Limited Two vil set (tive + tive) 10 Serum Institute of Indi Limited Vil 1 Serum Institute of Indi Limited Vil 2 Serum Institute of Indi Limited Vil 10 Shnth Biotehnis Privte Ltd. Vil 1 Shnth Biotehnis Privte Ltd. Vil 10 Diphtheri tetnus pertussis (ellulr) GlxoSmithKline Biologils SA Vil 1 Hemophilus influenze type Centro de Ingenirí Genéti y Biotenologí Vil 1 GlxoSmithKline Biologils SA Vil 1 GlxoSmithKline Biologils SA Vil 2 GlxoSmithKline Biologils SA Vil 10 Merk & Co., In. Vil 1 Novrtis Vines & Dignostis Srl Vil 1 Snofi Psteur SA Vil 1 Snofi Psteur SA Vil 10 Serum Institute of Indi Limited Vil 1 Heptitis A (dult) GlxoSmithKline Biologils SA Vil 1 Heptitis A (junior) GlxoSmithKline Biologils SA Vil 1 Heptitis B Bern Bioteh Kore Corp. Vil 1 Bern Bioteh Kore Corp. Vil (thiomersl free) 1 Bern Bioteh Kore Corp. Vil 2 Bern Bioteh Kore Corp. Vil 10 Bio Frm Unijet 1

55 APPENDIX 6 47 TABLE A6.1. ontd Doses/ primry Vine Mnufturer nme Presenttion ontiner Heptitis B Centro de Ingenirí Genéti y Biotenologí Vil 1 Centro de Ingenirí Genéti y Biotenologí Vil 10 GlxoSmithKline Biologils SA Vil 1 GlxoSmithKline Biologils SA Vil 10 GlxoSmithKline Biologils SA Vil 20 LG Life Sienes Vil 1 LG Life Sienes Vil 2 LG Life Sienes Vil 6 LG Life Sienes Vil 10 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Ampoule or Vil 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Ampoule or Vil 1 Shnth Biotehnis Limited Vil 1 Shnth Biotehnis Limited Vil 2 Shnth Biotehnis Limited Vil 6 Shnth Biotehnis Limited Vil 10 Shnth Biotehnis Limited Vil 20 HPV GlxoSmithKline Biologils SA Vil 1 Influenz sesonl GlxoSmithKline Biologils SA Vil 2 Merk & Co., In. Vil 1 GlxoSmithKline Biologils-Cnd Vil 10 Green Cross Corportion Vil 1 Green Cross Corportion Vil 10 Novrtis Vines & Dignostis Ltd Vil 10 Snofi Psteur SA Vil 10 Snofi Psteur-USA Vil 1 Snofi Psteur-USA Vil 10 Influenz, pndemi H1N1 CSL Limited A.C.N Vil 10 GlxoSmithKline Biologils-Germny Two vil set (tive + djuvnt) 10 Green Cross Corportion Vil 1 MedImmune Spryer 1 Novrtis Vines & Dignostis Ltd Vil 10 Novrtis Vines nd Dignostis Vil 17 Novrtis Vines nd Dignostis S.r.l. Vil 10 Snofi Psteur SA Vil 10 Snofi Psteur-USA Vil 1 Snofi Psteur-USA Vil 10 Serum Institute of Indi Limited Vil + Ampoule 1 Serum Institute of Indi Limited Vil + Ampoule 5 Jpnese enephlitis Biologil E Limited Vil 1 Chengdu Institute of Biologil Produts Co. Ltd Chin Vil 1 Chengdu Institute of Biologil Produts Co. Ltd Chin Vil 5 GPO-MBP Government Phrmeutil Orgniztion Merieux Biologil Produts Compny Limited Vil 4 Mesles Bio Frm Vil 10

56 48 REVIEW OF VACCINE PRICE DATA TABLE A6.1. ontd Doses/ primry Vine Mnufturer nme Presenttion ontiner Mesles Bio Frm Vil 20 GPO-MBP Co., Ltd. Vil 10 Snofi Psteur SA Vil 10 Serum Institute of Indi Limited Vil 1 Serum Institute of Indi Limited Vil 2 Serum Institute of Indi Limited Vil 5 Serum Institute of Indi Limited Vil 10 Mesles nd ruell Serum Institute of Indi Limited Vil 1 Serum Institute of Indi Limited Vil 2 Serum Institute of Indi Limited Vil 5 Serum Institute of Indi Limited Vil 10 Mesles, mumps nd ruell GlxoSmithKline Biologils SA Vil 1 GlxoSmithKline Biologils SA Vil 2 Merk & Co., In. Vil 1 Snofi Psteur SA Vil 1 Snofi Psteur SA Vil 10 Serum Institute of Indi Limited Vil 1 Serum Institute of Indi Limited Vil 2 Serum Institute of Indi Limited Vil 5 Serum Institute of Indi Limited Vil 10 Meningool A onjugte Serum Institute of Indi Limited Vil 10 Meningool A+C BioMnguinhos Vil 10 Snofi Psteur SA Vil 10 Meningool ACYW-135 (polyshride) Snofi Psteur-USA Two vil set (tive + exipient) 10 Meningool ACYW-135 (onjugte) Novrtis Vines nd Dignostis Two vil set (tive + tive) 1 Snofi Psteur SA Vil 1 Pneumool (onjugte) GlxoSmithKline Biologils SA Vil (10 vlent) 1 GlxoSmithKline Biologils SA Vil (10 vlent) 2 Pfizer Vil (13 vlent) 1 Pfizer Vil (7 vlent) 1 Polio vine intivted (IPV) Bilthoven Biologils Vil 1 Bilthoven Biologils Vil 5 GlxoSmithKline Biologils SA Vil 1 GlxoSmithKline Biologils SA Vil 2 Snofi Psteur SA Vil 10 Sttens Serum Institut Vil 1 Polio vine orl (OPV) Bio Frm Vil 20 ivlent types 1 nd 3 GlxoSmithKline Biologils SA Vil 10 GlxoSmithKline Biologils SA Vil 20 Hffkine Bio Phrmeutil Corportion Ltd Vil 20 Novrtis Vines nd Dignostis S.r.l. Plsti Tue 20 Snofi Psteur SA Vil 20 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Polio vine orl (OPV) monovlent type 1 Bio Frm Vil 20 GlxoSmithKline Biologils SA Vil 10 GlxoSmithKline Biologils SA Vil 20 Hffkine Bio Phrmeutil Corportion Ltd Vil 20 Novrtis Vines & Dignostis Srl Plsti Tue 20 Snofi Psteur SA Vil 20

57 APPENDIX 6 49 TABLE A6.1. ontd Doses/ primry Vine Mnufturer nme Presenttion ontiner Polio vine orl (OPV) monovlent type 2 GlxoSmithKline Biologils SA Vil 20 GlxoSmithKline Biologils SA Vil 10 Polio vine orl (OPV) monovlent type 3 GlxoSmithKline Biologils SA Vil 10 GlxoSmithKline Biologils SA Vil 20 Polio vine orl (OPV) trivlent Bio Frm Vil 10 Bio Frm Vil 20 GlxoSmithKline Biologils SA Vil 10 GlxoSmithKline Biologils SA Vil 20 Hffkine Bio Phrmeutil Corportion Ltd Vil 20 Novrtis Vines & Dignostis Srl Plsti Tue 10 Novrtis Vines & Dignostis Srl Plsti Tue 20 Snofi Psteur SA Vil 10 Snofi Psteur SA Vil 20 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Ries Zydus Cdil Vil 1 Chiron Behring Vines Privte Ltd. Vil 1 Novrtis Vines nd Dignostis Vil 1 Snofi Psteur SA Vil 1 Rotvirus GlxoSmithKline Biologils SA Plsti Tue 1 GlxoSmithKline Biologils SA Applitor 1 GlxoSmithKline Biologils SA Vil 1 Merk & Co., In. Plsti Tue 1 Ruell Serum Institute of Indi Limited Vil 1 Serum Institute of Indi Limited Vil 2 Serum Institute of Indi Limited Vil 5 Serum Institute of Indi Limited Vil 10 Tetnus toxoid Bio Frm Vil 10 Bio Frm Vil 20 Bio Frm Unijet 1 Biologil E. Limited Vil 20 Biologil E. Limited Vil 1 Biologil E. Limited Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 10 Ntionl Center of Infetious nd Prsiti Diseses Vil 20 Snofi Psteur SA Vil 10 Snofi Psteur SA Vil 20 Serum Institute of Indi Limited Ampoule 1 Serum Institute of Indi Limited Vil 10 Serum Institute of Indi Limited Vil 20 Shnth Biotehnis Limited Vil 10 Shnth Biotehnis Limited Vil 20 Typhoid Snofi Psteur SA Vil 20 Yellow fever BioMnguinhos Vil 5 BioMnguinhos Vil 10 BioMnguinhos Vil 50 Federl Stte Unitry Enterprise of Chumkov Institute of Poliomyelitis nd Vir Enephlitides of Russin Ad. Med. Si. Ampoule 2

58 50 REVIEW OF VACCINE PRICE DATA TABLE A6.1. ontd Doses/ primry Vine Mnufturer nme Presenttion ontiner Yellow fever Federl Stte Unitry Enterprise of Chumkov Institute of Poliomyelitis nd Virl Enephlitides of Russin Ad. Med. Si. Ampoule 5 Federl Stte Unitry Enterprise of Chumkov Institute of Poliomyelitis nd Virl Enephlitides of Russin Ad. Med. Si. Ampoule 10 Institut Psteur de Dkr Vil 5 Institut Psteur de Dkr Vil 20 Institut Psteur de Dkr Vil 10 Snofi Psteur SA Vil 10

59 APPENDIX 7 51 Appendix 7. Other vine prie dt soures 1. CDC vine prie list. In: Centers for Disese Control nd Prevention [wesite]. Atlnt, GA: Centers for Disese Control nd Prevention; 2015 ( 2. PAHO Revolving Fund. In: Pn Amerin Helth Orgniztion [wesite]. Wshington, DC: Pn Amerin Helth Orgniztion; 2015 ( ontent&view=rtile&id=1864&itemid=40713&lng=en). 3. Vine prie dt. In: UNICEF [wesite]. New York, NY: United Ntions Children s Fund; 2015 ( 4. Vine Produt, Prie nd Prourement (V3P) we pltform. In: World Helth Orgniztion [wesite]. Genev: World Helth Orgniztion; 2015 (

60 The WHO Regionl Offie for Europe The World Helth Orgniztion (WHO) is speilized geny of the United Ntions reted in 1948 with the primry responsiility for interntionl helth mtters nd puli helth. The WHO Regionl Offie for Europe is one of six regionl offies throughout the world, eh with its own progrmme gered to the prtiulr helth onditions of the ountries it serves. Memer Sttes Alni Andorr Armeni Austri Azerijn Belrus Belgium Bosni nd Herzegovin Bulgri Croti Cyprus Czeh Repuli Denmrk Estoni Finlnd Frne Georgi Germny Greee Hungry Ielnd Irelnd Isrel Itly Kzkhstn Kyrgyzstn Ltvi Lithuni Luxemourg Mlt Mono Montenegro Netherlnds Norwy Polnd Portugl Repuli of Moldov Romni Russin Federtion Sn Mrino Seri Slovki Sloveni Spin Sweden Switzerlnd Tjikistn The former Yugoslv Repuli of Medoni Turkey Turkmenistn Ukrine United Kingdom Uzekistn World Helth Orgniztion Regionl Offie for Europe UN City, Mrmorvej 51, DK-2100 Copenhgen Ø, Denmrk Tel.: Fx: Emil: Wesite: ISBN >