OBJECTIVES: The aim of this study is to evaluate vaccine pricing and the differences in the costs of vaccines between high income (HICs) and low income (LICs) countries.

METHODS: The WHO V3P price database was reviewed for the price of seven vaccines (Rotavirus vaccine, Human Papillomavirus [HPV] vaccine, Pneumococcal Conjugate vaccine [PCV], Varicella vaccine, Yellow Fever [YF] vaccine, Influenza A vaccine, Inactivated Poliovirus vaccine [IPV]). Each vaccine was reviewed for price in either 2014 or 2015, in each available country income group (HIC, upper-middle [UMIC], lower-middle [LMIC], Pan American Health Organization (PAHO), and UNICEF]).

RESULTS: A number of vaccines were found to have exponentially higher prices in HICs compared to other income groups, such as Varicella and PCV (in these, median price in HICs was over 2.5 times UMIC price). Results also showed that differences in vaccines prices between HICs and LICs were greatest in newer vaccines. An exception was the YF vaccine, where the median price was lower in HICs than UMICs or LMICs ($18.92, $19.96, $26.58 respectively), which may be to the endemicity of YF in LICs such as South America.

CONCLUSIONS: Vaccine prices vary according to country income, but there are other considerations that can impact the price, such as the epidemiology of the disease and how long a vaccine has been available in the market. Tiered-pricing or pooled procurement are methods employed by HICs or LICs to procure vaccines; however these processes are not transparent, so it is difficult to determine the vaccine price that should be set in different market.

Further research to investigate the exact methods for vaccine price setting is needed, as well as a comprehensive review of vaccine affordability in LMICs and UMICs and how it impacts global vaccine pricing