Pfizer has responded to criticism over the prices it has agreed to supply its pneumococcal vaccine Prevenar 13 to the Global Alliance for Vaccines and Immunisation (GAVI) alliance for children in the world’s poorest countries.

The drugs giant has linked up with GAVI on a new supply agreement to provide additional doses of Prevenar 13. Pfizer has committed to supply the United Nations Children's Fund (UNICEF) with up to 260 million doses of Prevenar 13, at a reduced "tail price" until 2025. This is in addition to 480 million doses of the vaccine already committed through previous deals.

The tail price is the reduced cost per dose set by the manufacturer and paid by GAVI and the remaining amount is paid by the financing mechanism, called the Advance Market Commitment (AMC) designed to accelerate rollout of vaccines in the world’s poorest countries and is administered by GAVI.
Pfizer will offer Prevenar 13 through the AMC at $3.40 per dose for the remainder of this year, at which time the price will further decrease to $3.30. Since the firm's original AMC agreement in 2010, more than 20 countries have introduced Prevenar 13 into their immunisation programmes.

GlaxoSmithKline has also signed a new agreement to provide an additional 240 million doses of Synflorix to developing countries over the next ten years, at $3.40 per dose. The UK firm said it will help protect up to 80 million more children from pneumococcal diseases such as meningitis and pneumonia.

However the deals provoked a hostile response from Medecins Sans Frontieres. The charity claimed that the price reduction "of just $0.10 represents barely a 3% discount for developing countries on a vaccine which Pfizer and GSK currently receive the vast chunk of a $1.5 billion subsidy".

Price cut not enough: MSF

Kate Elder, vaccines policy adviser at MSF Access Campaign, said "any price reduction on the pneumococcal vaccine is welcome", but claims that Pfizer and GSK could have offered a much steeper cut. She argues that the two companies "are still reaping the benefits of the AMC subsidy - 73% of the $1.5 billion subsidy has been promised to the companies".

Ms Elder added that MSF is "unable to systematically access the…vaccine at the GAVI negotiated prices, meaning vulnerable children, including refugees, continue to miss out on the benefits".
In response to MSF's claims, Pfizer told Pharma Times that the AMC price is "reflective of the low economic status of the GAVI-eligible countries" participating in the scheme. It added that should non-GAVI-eligible countries require the AMC price, "they could jeopardise the global system that has so effectively made needed vaccines available to the poorest countries at an affordable, sustainable price".
Pfizer added that “the few, but vocal, AMC critics underestimate the costs associated with manufacturing Pfizer’s pneumococcal conjugate vaccine – one of the most complex biologic products manufactured today". In addition, the company said that "these critics do not take into account the magnitude of the required operating costs and substantial capital and supply chain investments associated with pneumococcal conjugate vaccine technology".

Pfizer goes on to say that its therapy is essentially the combination of thirteen separate vaccines in one and "it takes approximately one year to create one batch of Prevenar 13, encompassing some 500 separate quality control tests prior to product release and distribution, multiple facilities and hundreds of trained professionals".