ABSTRACT
THE WORLD VACCINE MARKET, PRESENT AND FUTURE The notion that vaccines constitute a credible and reliable financial market is fairly recent. Apart from smallpox (Jenner), rabies (Pasteur), and inactivated whole-cell parenteral typhoid vaccine (Wright and Pfeiffer) (see chap. 1), almost all vaccines were discovered in the 20th century, mostly in the second half of the century. During the first years of the 21st century, six new vaccines have already been licensed, expanding the number of vaccine-preventable diseases from 22 to 25. Within the pharmaceutical industry, vaccines were historically set apart because of the close interactions between industry and public health authorities in relation to these products; for many years, they were basically viewed as not-for-profit or minimal-profit products (1). As a result, as recently as the late 1980s, most pharmaceutical companies were leaving the field of vaccines (2). A number of factors have combined to reverse the tide so that today vaccines are a much more competitive commercial area (3). Nevertheless, the field remains at best a ‘‘qualified’’ market that is strongly regulated and has high entry barriers and supply constraints, is largely ‘‘monopsonistic’’ in nature, and must adjust to specific price-setting mechanisms (4).
