Abstract
Background
In the first year since their introduction, the number of doses of COVID-19 vaccines delivered (12.5 billion) was more than double that for all other vaccines together (5.5 billion). Similar trends are expected when comparing immunization expenditures as the price of vaccines is a key cost driver of vaccination costs.
International data compiled by UNICEF Supply Division show that COVID-19 vaccine prices range widely, from less than $2 to more $40 per dose in the public market, with higher prices in private markets. Yet, we lack a clear understanding of how the variation of prices may affect immunization expenditures in the middle to long term. As we move from emergency response to longer-term planning, it is essential to examine the impact that COVID-19 vaccine procurement costs have had on national health expenditures and, in particular, vaccine prices as a key cost driver.
Research question or aim
The purpose was to provide policy makers with an analysis of evidence on COVID-19 vaccine prices and vaccine procurement expenditures to plan for future funding needs and sustainability of immunization financing.
Objectives
To understand how COVID-19 vaccine prices have varied across vaccine types, countries/regions and procurement arrangements
To understand drivers and factors associated with COVID-19 vaccine prices
To investigate the impact of COVID-19 vaccine procurement on immunization expenditures
To draw recommendations to promote immunization and health equity goals
Methods
We triangulated data from literature review and interviews:
Analysis of COVID-19 vaccine price data publicly available from UNICEF Supply Division COVID-19 Vaccine Market Dashboard, and from other UNICEF, WHO, Gavi and MSF sources
Review of published literature through a PubMed search on COVID-19 vaccine prices, complemented with Google Scholar, and grey literature from stakeholders contacted
Consultation/interviews with key stakeholders, to clarify and expand data available
Key results
We screened more than 700 peer-reviewed articles from PubMed and extracted data from 70 included articles. The review showed that data on COVID-19 prices and expenditures are scarce. Most references contained global level data with only a few revealing country specific vaccine prices. Hence, the UNICEF COVID-19 vaccine market dashboard was the most important source.
There was wide variation of prices across vaccine products, with greater price variation observed between vaccine manufacturers than between countries. The median price per COVID-19 vaccine dose was lowest in South Asia (US$ 2.5) and highest in Europe and Central Asia (US$ 17.5). However, this analysis is limited by the data publicly available, and final prices may differ as the prices agreed between country and manufacturer are most often kept confidential.
Implications for policy and practice
This study enhances our understanding of how COVID-19 vaccine prices affect the sustainability of immunization financing, particularly for low- and middle-income countries. Recommendations will be drawn to support global immunization financing and health equity goals.