Preparing for Launch: Market Access Planning for a Tetravalent Dengue Vaccine Candidate

Abstract

Over half of the world’s population lives in dengue-endemic regions, and hundreds of millions of people are infected by the virus each year. A handful of organizations are working to develop a safe and effective vaccine against this global public health threat. This dissertation conveys the experience of an 8-month field assignment to help develop the global market access strategy for Takeda Pharmaceuticals’ dengue vaccine candidate. The field work followed a 3-step methodology, based on the following essential pillars of vaccine market access: evidence generation, pricing approach, supplementary health initiatives, supply chain, and the policy approach. The first step was to specifically describe these pillars for the dengue vaccine candidate. The second step was to categorize potential launch countries based on shared market characteristics. The culminating step was to craft a strategic direction for combinations of the market access pillars and country categories generated in the first two steps. This process resulted in a document presenting Takeda’s market access approach for the dengue vaccine. During implementation of the first step, a new market access pillar was added to highlight the people and communities that would potentially use the vaccine. The second step produced four country categories: endemic countries with high readiness for vaccine adoption, endemic with gaps in readiness, travel markets, and markets that rely on supranational funding. The third step created a set of global strategic directions for the dengue vaccine. Country teams will then rely on this guidance to develop national market access plans. The field work generated insights that are applicable to the broader domains of public health and pharmaceutical products. Above all, the experience delineated the concepts of ‘market access’ and ‘access to medicines’; current literature and practice sometimes conflate these terms, and market access is often defined as a process. The work underscored the importance of going beyond a process-only definition of market access in order to assess its aims, assumptions and outcomes. Further insights relate to the significance of language used by public health and corporate stakeholders, the importance of leadership and organizational values in shaping market access, and the crucial role of country teams for implementation.