Britain, home of the discovery of the world’s first ever vaccine, has long been championing a pharma sub-segment forecast to reach a global market value of USD 49.27 billion by 2022. However, despite possessing the innovators, the infrastructure and the coverage, the UK’s thriving vaccine industry risks being blown off course by a fragile ecosystem that needs constant attention, protection and investment.

“As a culture, we display very little of the vaccine hesitancy that is commonly encountered in markets like Germany, France and Italy”

Richard Torbett, ABPI

Not only is the UK internationally renowned and recognized by the EU and WHO as a world-beater in vaccines development and innovation courtesy of the longstanding contribution of iconic British enterprises such as GSK and AstraZeneca, but the country also stands out as something of a role model and leading proponent of their application. The announcement, last year, that Innovate UK would be investing GBP 66 million in the establishment of a state-of-the-art national vaccines development and manufacturing center to prepare the country for emergency epidemics as part of the Government’s rebooting of its industrial strategy is a case in point.


“Here in Britain, I am glad to say we enjoy especially high coverage rates and a robust pediatric schedule that, for many categories, sees as much as 95 percent of eligible cohorts inoculated. Furthermore, as a culture, we display very little of the vaccine hesitancy that is commonly encountered on the continent in markets like Germany, France and Italy.


Even when there is the odd scare story such as the scaremongering over the MMR vaccine following a disreputable publication, then our media has generally proved itself to be responsible in stemming the oxygen of publicity and in rebuilding public confidence,” opines Richard Torbett, executive director of commercial policy at the Association of the British Pharmaceutical Industry (ABPI).


He warns, however, that vaccines constitute a special sub-segment of the pharmaceuticals market that requires particular cultivation and attention if Britain’s leadership position is to be maintained. “We already possess some of the best companies, a long legacy and excellent cutting-edge science, but it’s essential that we also get the policy frameworks right because, at the end of the day, vaccines represent a tough market space where fewer and fewer companies seem to want to compete,” he notes.


“From a regulatory standpoint, vaccines are treated outside of the conventional NICE infrastructure, and are subjected to their own bespoke oversight regime ultimately because it’s quite a sensitive ecosystem whereby you’re administering them to millions of patients so there are necessarily additional safeguards around public safety that have to be factored in. Because of these distinctions, however, it’s fundamentally important to ensure that the policy dimension keeps pace with the evolving needs of the industry,” urges Torbett.


Meanwhile, the association has expressed profound concern at recent recommendations put forward by an independent Cost-effectiveness Methodology for Immunization Programs and Procurement (CEMIPP) Group, which, if implemented, could risk impacting negatively on the health of the nation by rendering it harder for patients to access vaccines on the National Health Service (NHS).


The CEMIPP Group was originally established in 2016 at the behest of the Department of Health and Social Care in the wake of delays of the Joint Committee on Vaccination and Immunisation (JCVI) recommending the meningitis B vaccine for use in the NHS and a public outcry over the death of a two-year-old girl who contracted meningitis B after being assessed as too old to be eligible for receipt of the appropriate vaccine under the state system. Mandated to review whether prevailing techniques for appraising vaccination programs remain appropriate, its experts put forward recommendations that could restrict access to vaccines.


They are, for example, advocating a lowering the cost-effectiveness threshold from GBP 20,000 per quality-adjusted life year (QALY) to a mere GBP 15,000 in a bid to force down the price the public health system pays for any vaccine, and, in doing so, risk an outcome in which expensive vaccines, irrespective of their desirability in meeting public health needs, may be denied approval.


“The irony in all of this is that the Group was set up because an unprecedented 820,000 members of the public petitioned parliament for changes to the rules because they wanted wider access to vaccines, and yet the reforms being proposed would most likely achieve precisely the opposite effect,” exclaims the ABPI’s value and access director, Paul Catchpole.


“The UK currently has a world-leading immunization program so we must be very careful not to jeopardize this… Moreover when you consider that, globally, there are some 270 exciting new vaccines under development at the moment that will soon be coming out of the pipeline and can be deployed not only to prevent infectious disease, but also serve as treatment pathways to stimulate the immune system to target diseased cells in conditions like cancers and Alzheimer’s, then we want to be doing all we can to increase uptake, not dampen it,” he argues.


Richard Torbett concurs. “There’s a tendency to underestimate the enormous underlying value of vaccines. The chief medical officer recently calculated that they generate some GBP 6.6 billion of savings every year, which means they constitute an incredibly clinically cost-effective treatment pathway. Moreover it’s difficult to capture the full extent of the benefits when so much of what they do is about preventing the contraction of a disease in the first place. Along with clean water, vaccines can truly be considered one of the most effective health interventions out there and, in this day and age, when there is so much concern over the inappropriate use of antibiotics and the rise of antimicrobial resistance, vaccines take on ever-greater importance. Thus this is an industry that must be cherished and nurtured,” he concludes.

Writer: Louis Haynes