Vaccine Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 368

13.2.3 Threat of Substitutes and Supplier Power

Vaccines face two types of substitutes: alternative methods for preventing an infec-
tion and therapies for dealing with the consequences of being infected. For example,
forthcoming malaria vaccines will compete with alternative prevention methods such
as mosquito nets, insect repellents, and preventive drugs such as Lariam (mefl o-
quine), as well as antimalarial medications such as artemisinin. Sexual abstinence to
prevent HPV infection is one type of substitute for HPV vaccines, and therapies for
genital warts, as well as pap testing and therapies for cervical cancer, are other kinds
of substitutes for HPV vaccines. Antivirals such as Tamifl u and Relenza, which are
administered to fl u-stricken persons, are substitutes for fl u vaccines. A price increase
and/or performance decline of substitutes should increase the demand for vaccines and
vice versa. Phelps ( 1978 ) and Nordquist and Wu ( 1976 ) have indeed shown that an
increase in the price of curative medical care increases the demand for prevention,
and demand for prevention may decline when health insurance lowers the price of
curative care (Kenkel 2000 ).
As far as suppliers are concerned, some markets for critical vaccine manufacturing
technologies and equipments (e.g., ultra centrifuges) are dominated by one or two
suppliers, who command signifi cant bargaining power. Small biotech and technol-
ogy providers with valuable and rare technologies are also in a strong bargaining
position vis-à-vis vaccine manufacturers.

13.3 Vaccine Customers

Like for therapeutics, the key customer roles of (1) consuming (receiving the
vaccination), (2) buying (selecting the vaccine), and (3) paying (fi nancing the pur-
chase) are typically carried out by different persons or organizations. Table 13.5
provides examples of persons and organizations carrying out these roles in the vaccine
market, and Fig. 13.4 shows a customer map.
W e fi rst describe the two main types of customer role confi gurations, namely
private and public markets, and then discuss the following stakeholders: consumers,
vaccine prescribers, organizations issuing vaccination recommendations, vaccine
purchasers, and vaccination advocates and opponents.

13.3.1 Private and Public Markets

Vaccine markets are characterized as “private” or “public” markets, depending on
who the buyers and payers are. In private markets, consumers and/or private insur-
ers are the buyers and payers, whereas public players such as federal and regional
governments buy and pay in public markets. Each specifi c vaccine generally com-
petes in both private and public markets, with the sales mix depending on the