Vaccine Presentation Assessment Tool Andrew Garnett TECHNET Consultation, Tunis, Tunisia 2 4 Decembe

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Vaccine Presentation Assessment Tool Andrew
Garnett TECHNET Consultation, Tunis, Tunisia
2 4 December 2008
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Problem statement

• Intrinsic conflict exists between safety and
  wastage challenges associated with multi-dose
  vaccines, and increased cold chain capacity
  requirements associated with single dose.
• Wastage policy used to be much more tolerant new
  expensive vaccines require an evidence-based
  approach.
• Vaccine manufacturers look to public sector for
  clear guidance on preferred vial size(s) due to
  technical and financial constraints of their
  manufacturing procedures.

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The driver for VPAT

• In the context of malaria RTS,S and pneumococcal
  vaccines we initiated an analysis covering
• Anticipated vaccine cost per purchased dose.
• Anticipated wastage.
• Cost of storage, distribution, consumables
  (syringes and safety boxes) and waste disposal.

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Basis of Vaccine Presentation Assessment Tool

• There is a break-even wastage rate for each
  multi- dose or pre-filled vaccine
  presentation at each possible price point,
  such that the cost per delivered dose of
  every combination is equal to the cost per
  delivered dose for a single-dose presentation.
• If the wastage rate for a combination of price
  and presentation is realistically
  achievable, then that combination is
  operationally equivalent, or more efficient
  than a single dose presentation.
• This is the basis of VPAT.

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Finalising the tool

• Tool is nearing completion, BUT
• Wastage data used to make the judgement on
  preferred presentation are largely based on the
  old supermarket approach, and are often
  incomplete and inaccurate.
• Cost data on cold chain operations are limited
  and come from random sources.
• Therefore, modern data are needed to populate
  the database.

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Acknowledgements

• VPAT has been developed with support from the
  PATH Malaria Vaccine Initiative, with funding
  from the Bill and Melinda Gates Foundation and
  the GAVI Alliance.

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Thank you