The relationship between pediatric combination vaccines and market effects.

We explored market factors that affect pediatric combination vaccine uptake in the US public-sector pediatric vaccine market. We specifically examined how Pediarix and Pentacel earned a place in the 2009-2012 lowest overall cost formulary. Direct competition between Pediarix and Pentacel is driven by the indirect presence of the Merck Haemophilus influenzae type b vaccine and the Recommended Childhood Immunization Schedule requirement for a hepatitis B birth dose.

Pricing strategies for combination pediatric vaccines based on the lowest overall cost formulary.

This paper analyzes pricing strategies for US pediatric combination vaccines by comparing the lowest overall cost formularies (i.e., formularies that have the lowest overall cost).

Pricing strategies for combination pediatric vaccines and their impact on revenue: Pediarix or Pentacel?

This paper analyzes pricing strategies for pediatric combination vaccines and their impact on the United States pediatric vaccine market. Three pharmaceutical companies compete pairwise with each other over the sale of vaccines containing two or three antigens per injection. Specific emphasis is placed on examining the competition between two pentavalent vaccines: GlaxoSmithKline's Pediarix (DTaP-HepB-IPV) and Sanofi Pasteur's Pentacel (DTaP-IPV/Hib).

Maximizing the effectiveness of a pediatric vaccine formulary while prohibiting extraimmunization.

The growing-complexity of the United States Recommended Childhood Immunization Schedule has resulted in as many as five required injections during a single well-baby office visit. To reduce this number, vaccine manufacturers have developed combination vaccines that immunize against several diseases in a single injection. At the same time, a growing number of parents are challenging the safety and effectiveness of vaccinating children.

A web-based tool for designing vaccine formularies for childhood immunization in the United States.

This article describes the motivation, development, and implementation of a software tool, www.vaccineselection.com, introduced to assist health care professionals and public health administrators in managing pediatric vaccine purchase decisions and making economically sound formulary choices.

Survey of vaccine distribution and delivery issues in the USA: from pediatrics to pandemics.

Vaccine distribution and delivery has become an issue of significant interest, given the threat of a pandemic influenza outbreak and the resulting need for coordinated efforts to distribute and deliver pandemic influenza vaccines into the hands of healthcare workers responsible for administering them. This review provides an overview of the issues that are most relevant to vaccine distribution and delivery, including routine pediatric immunization, combination vaccines, vaccine shortages and stockpiling, seasonal influenza vaccines and, of most current interest, a discussion on pandemic influenza outbreak issues and a list of future distribution and delivery challenges that may be faced during such an event.

An analysis of the pediatric vaccine supply shortage problem.

In 2002, several factors resulted in pediatric vaccine manufacturers not being able to produce a sufficient number of vaccines to vaccinate all the children in the United States according to the Recommended Childhood Immunization Schedule. The resulting vaccine supply shortage resulted in thousands of children not being fully immunized according to this schedule, and hence, created an unnecessary risk for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention responded to this crisis by using pediatric vaccine stockpiles to mitigate the impact of future shortages.

Stockpile levels for pediatric vaccines: how much is enough?

In recent years, several factors have led to pediatric vaccine manufacturers experiencing vaccine production interruptions that resulted in vaccine supply shortages. One unfortunate consequence of such events is that not all children in the United States could be vaccinated on time, as set forth by the Recommended Childhood Immunization Schedule, and hence, created the potential for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention (CDC) have responded to such events by releasing vaccine supplies from the national pediatric vaccine stockpiles, which were designed to mitigate the impact of vaccine production interruptions.

Engineering the economic value of two pediatric combination vaccines.

Combination vaccines for pediatric immunization have become an effective means to reduce the number of separate injections required to immunize children according to the United States Recommended National Childhood Immunization Schedule. This paper reports the results of using operations research methodologies to analyze the price and value of two pentavalent combination vaccines for pediatric immunization: diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated polio (DTPa-HBV-IPV) and diphtheria-tetanus-acellular pertussis, Haemophilus influenzae type B, inactivated polio (DTPa-HIB-IPV). These two combination vaccines are analyzed both individually and head-to-head, as a function of the cost of administering (or avoiding) an injection and the number of doses of the vaccine required to be in the lowest overall cost vaccine formulary.

Assessing the impact of wastage on pediatric vaccine immunization formulary costs using a vaccine selection algorithm.

Pediatric immunization is an important factor in providing protection against numerous common preventable diseases. The success of the pharmaceutical industry in developing new pediatric vaccines has resulted in a crowded recommended immunization schedule requiring several clinic visits over the first 12 years of life. Operations research models have been developed and used to make economically sound procurement choices from among a growing number of competing vaccine products.

Designing pediatric vaccine formularies and pricing pediatric combination vaccines using operations research models and algorithms.

The National Immunization Program, housed within the Centers for Disease Control and Prevention in the USA, has identified several challenges that must be faced in childhood immunization programs to deliver and procure vaccines that immunize children from the plethora of childhood diseases. The biomedical issues cited include how drug manufacturers can combine and formulate vaccines, how such vaccines are scheduled and administered and how economically sound vaccine procurement can be achieved. This review discusses how operations research models can be used to address the economics of pediatric vaccine formulary design and pricing, as well as how such models can be used to address a new set of pediatric formulary problems that will surface with the introduction of pediatric combination vaccines into the US pediatric immunization market.

Analyzing the economic value of the hepatitis B--Haemophilus influenzae type B combination vaccine by reverse engineering a formulary selection algorithm.

Combination vaccines for pediatric immunization provide a means to reduce the number of separate injections required to immunize children. This paper reports the results of reverse engineering a vaccine selection algorithm to evaluate the economic value of a hepatitis B-Haemophilus influenzae type B combination vaccine that is currently under federal contract in the United States. This analysis captures the tradeoff between the cost assigned to administering an injection and the price of the vaccine that earns it a place in the lowest overall cost formulary.

Using Monte Carlo simulation to determine combination vaccine price distributions for childhood diseases.

The Recommended Childhood Immunization Schedule provides guidelines that allow pediatricians to administer childhood vaccines in an efficient and effective manner. Research by vaccine manufacturers has resulted in the development of new vaccines that protect against a growing number of diseases. This has created a dilemma for how to insert such new vaccines into an already crowded immunization schedule, and prompted vaccine manufacturers to develop vaccine products that combine several individual vaccines into a single injection.