Tendering process for pneumococcal conjugate vaccine

Main message:

Question: How should vaccine products be compared in the national procurement of the pneumococcal conjugate vaccine in Finland? Answer: 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: What criteria should be used when comparing pneumococcal vaccine products? How should the health effects of pneumococcal vaccination be assessed? How should the cost-effectiveness of pneumococcal vaccination be evaluated? Participation happened in two ways with these instructions: Write your comments into the comment box at the end of each substance page. Moderator will include it into the text of the page. Sign in Opasnet and participate by editing the talk pages of any substance page. See instructions for discussion and wiki editing. You should first browse the pneumococcus assessment pages so that you can give your comments on a right page and check whether your comment has actually been raised already. Comments are not repeated, and irrelevant comments will be removed. All relevant content will stay on the pages. Please note, however, that other participants may try to prove your comments false; if proven false, your comments as such will not be reflected in the final recommendation that is given to NITAG and the Ministry of Social Affairs and Health.

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Question

How should vaccine products be compared in the national procurement of the pneumococcal conjugate vaccine?

Scope

• 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 [1](pdf)).
• The procurement must follow the Act on Public Contracts.
• The discussion on these pages is not binding the preparation of the procurement.

Answer

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.

Rationale

The rationale has been summarised in the following three pages: Comparison criteria for pneumococcal vaccines, Epidemiological modelling and Economic evaluation.

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).

See also

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