Tendering process for pneumococcal conjugate vaccine
In brief, the suggestion is to use vaccine price only, because the two products in the market are very similar in respect to their efficacy and (minimal) side effects.
To answer this question, THL organised an open discussion during summer and early autumn 2014. The outcome of this process was presented to the National Immunization Technical Advisory Group (NITAG) and the Ministry of Social Affairs and Health in September. The discussion focussed on three topics:
Participation happened in two ways with these instructions:
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How should vaccine products be compared in the national procurement of the pneumococcal conjugate vaccine?
- We restrict the analysis to vaccination within the infant immunisation programme.
- We specify criteria for comparing pneumococcal conjugate vaccine products.
- The aim is to prepare selection criteria that enable the choice of the economically most advantageous tender.
- We discuss assumptions underlying the epidemiological model and the cost-effectiveness analysis.
- The preparation of the criteria is based on current knowledge of the impact of pneumococcal conjugate vaccination.
- The procurement can only involve a product that has marketing authorisation in EU/Finland (see Section 20a of the Medicines Act (pdf)).
- The procurement must follow the Act on Public Contracts.
- The discussion on these pages is not binding the preparation of the procurement.
A preliminary answer was to base the selection criteria on the vaccine price and the predicted impact of vaccination on invasive pneumococcal disease in the entire Finnish population. Safety will not be used as one of the criteria because there is no indication about any differences in the safety of the currently licensed pneumococcal vaccine products.
An epidemiological model was applied to assess the differences between the 10- and 13-valent vaccines in quality-adjusted life-years gained and in medical costs saved. If serotype 3 included in the 13-valent vaccine does not induce population level (indirect) effects, then the differences between the two vaccines in quality-adjusted life-years gained and in medical costs saved are small in comparison to differences in predictions due to intrinsic uncertainties in the model. Therefore, the vaccines can be regarded as equally effective and vaccine price should be the predominant selection criterion.
Comparison of vaccine products will be based on their price and expected health benefits (Comparison criteria for pneumococcal vaccines). The health benefits mean the expected reduction in the annual number of invasive pneumococcal disease in the Finnish population, if the vaccine would be used in the national infant immunisation programme. The assessment of the benefits is realised by using an epidemiological model. The effectiveness of the vaccination programme will be quantified as the expected improvement in health-associated quality of life. The selection criterion is formulated so that the most cost-effective will be identified (Economic evaluation).
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