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Sunday, September 25, 2016

Beyond the Vial: A Social Value Business Model For Sanofi Pasteur’s Dengue Vaccine

Dr. Su - Peing Ng, Global Medical Director of Sanofi Pasteur is joined by Lee Kuan Yew School of Public Policy Professor Tikki Pang at a recent launch of Sanofi’s dengue vaccine, Dengvaxia last Sept 20 at New World Hotel Makati with Sanofi officials and media.

Dr Su-Peing Ng and Professor Tikki Pang discussed with members of the press the latest scientific evidence or data on the dengue vaccine and how it prevented the rise of dengue fever in the country.

Dengue is a serious and complex disease. The mosquitos that transmit dengue indiscriminately pass the disease amongst people of all ages and socio-economic levels.  About half of the world’s population lives in areas where dengue is endemic, and millions suffer its seemingly bone-breaking pain and severe fevers, each year. Its reach has grown 30-fold in the last 50 years, swelling with globalization, urbanization, and climate change. Global costs of dengue are around $9 billion, annually . But in the years ahead, the tide of dengue could be better controlled through enhanced international collaborations in public health, and an innovative social business model with a vaccine at its core.

Twenty years ago, Sanofi Pasteur identified the potential scale of the dengue problem at its early stages, and began to put in place a set of innovative scientific and industrial solutions. In 2015, the dengue vaccine received its first market approvals.  In July 2016, after more than two years of review processes and inputs from clinical trial data and from top global dengue and infectious diseases experts, the World Health Organization issued its recommendation that countries where the dengue burden is high should consider vaccine introduction as part of integrated dengue prevention and control measures. As of September 14th 2016, the vaccine waslicensed in 9 endemic countries in Asia and Latin America  and public immunization programs are underway in Brazil and the Philippines, while the vaccine is also available on the private markets in those countries as well as in Mexico and El Salvador.

The story behind the vaccine is one of hard-earned research and development – but you’ve heard that story before. This story goes beyond the vial, as well: It’s about a new, social value business model that Sanofi Pasteur has built in collaboration with dengue-endemic countries and global health institutions. In time, it can help control dengue. But as importantly, it can help to support better healthcare outcomes in emerging markets by accelerating access to needed innovations.

When Sanofi Pasteur first identified a viable dengue vaccine candidate, we saw the opportunity to develop a health solution specifically for the countries where the dengue burden is highest.  We wanted to make sure that people who lived in grip of dengue’s threat were the people for whom the vaccine is designed and delivered primarily.  It sounds simple enough but in traditional pharmaceutical business models, this is often not the case.  More often than not, travelers and other select groups of individuals from high-income countries have access to new preventive tools against tropical diseases first, at a premium, before these solutions are made available, often as many as 10 years later, in less rich economies, even if this is where the disease burden is heaviest.

Our faith in this“flipping the model” approach was inspired by the scale of the dengue problem. Vaccines are widely considered among the most effective healthcare interventions against infectious diseases. They often confer protection against a disease that extends beyond the vaccinated to also the unvaccinated population. Given dengue’s massive spread, a vaccine could help national authorities in dengue-endemic countries achieve WHO 2020 objectives for dengue reductions in mortality (50%) and morbidity (25%) if it is implemented in large-scale public health programs1.

We anticipated this, and began building robust public health collaborations and industrial resources essential to success. The global clinical development program of the vaccine included 40,000 participants in 15 countries across Asia and Latin America ,  ,  . We invested in extensive skills training for healthcare personnel, upgraded healthcare facilities and increased prevention and education efforts. We captured new scientific insights into dengue epidemiology and transmission which is shared with host governments.  In parallel, Sanofi Pasteur built a dedicated dengue-vaccine production facility that will allow large and cost-effective supply to support optimal uptake of the vaccine as needed around the world.

Successful implementation of dengue vaccination programs can help governments in dengue-endemic countries to take control over the disease. Mathematical modeling of the vaccine’s impact indicate  that if countries take up broad public vaccination programs in highly dengue-endemic countries like those that participated in the Phase III development of the vaccine, vaccination can help cut the burden of disease in half over five years . Healthcare systems’ loads can be lightened and they can attract further outside public health investment with demonstrated program results. Successful vaccination programs therefore have the potential to be catalysts for social and economic progress.  Today, states like Paraná in Brazil are taking up the lead in this effort.  Public program introduction of the dengue vaccine in Mexico has been recommended by CONAVA, that country’s National Vaccination Council. Countries like these that have participated in the clinical development of the vaccine can see the value in the entire process as well as in the potential future results.

At Sanofi Pasteur, we welcome enhanced support and investment in the robust public-private collaborations that ensure broad reach for innovative health solutions like the dengue vaccine. Working together to establish balanced trust and long-term commitment to new ways of bringing innovation to people is critical to unlocking innovative business models’ fullest potential for improving public health worldwide.

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