1. H1N1 Vaccine Production Namrata Uberoi - Andrew Helicher HPA 545 December 1, 2009

3. Established manufacturer of the seasonal flu vaccine

5. Risk Assessment

6. Profitability Analysis

7. Recommendation

8. Problem Definition

9. Risk Assessment

10. Profitability Analysis

12. H1N1 Options Utilize existing capacity Build a vaccine plant Purchase an existing vaccine plant Do not enter the market 5

14. Risk Assessment

15. Profitability Analysis

18. Virus production

19. Costs

20. Legal liability 8

22. Pre-order payment

23. Other revenue streams9

25. Risk Assessment

26. Profitability Analysis

29. Bertrand Paradox2

30. Monopsony1

31. Fixed Cost to Market Size3

32. Hershaft index

33. Govn. price based on AWP3

34. Regionalshortages1Herrick, D., 2004 Wikipedia, 2009 Danzon, P. et al., 2005

36. Severe in early months2

37. Recommended population3

38. Government subsidies

39. Extended vaccination timeline3

40. 1 dose needed (vs. 2)

41. Virus responds to antivirals

42. Fear of getting sick from vaccine3

43. Mild winter perception3

44. Winner’s curse4Putting Influenza H1N1 in its Place, 2009 Yoo et.al, 2009 Orenstein, W. et al, 2008 Danzon, P. et al., 2005

46. Market restrictions

47. Input shortage/price increase

48. Aging technology

49. Government subsidies

50. New firms enter market (H1N1)

51. New technology

52. Nasal spray2

53. Cell-culture1Danzon, P. et al., 2005 Orenstein, W. et al, 2008

55. Management

56. Regional regulations

57. Small market1

58. $6B vs. $340B (pharma)

59. Inputs (eggs)

60. Labor-intensive

61. Technology

62. Distribution channelsEconomies of Scale Economies of Scope Brown, D., 2004

64. Risk Assessment

65. Profitability Analysis

67. Lobby for supply-side and demand-side subsidies

68. Supply-side: pricing, inventory buy-back, liability

69. Demand-side: insurance, public health, mandates

71. References 19 Bertrand Paradox. Retrieved from http://en.wikipedia.org/wiki/Bertrand_paradox_(economics). 2009 Nov. 29. Brown, D. (2004 Oct. 17) How U.S. Got Down to Two Makers of Flu Vaccine. Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/articles/A38776-2004Oct16.html. Collin, N. & Radigues, X. (2009) Vaccine production capacity for seasonal and pandemic (H1N1) 2009 influenza. Vaccine. Vol. 27, 5184-5186. Danzon, P., Pereira, N. & Tejwani, S. (2005) Vaccine Supply: A Cross-National Perspective. Health Affairs. Vol. 24, No. 3. Feeney, M. (2006) Flu Vaccine Case Study. The Electronic Hallway. Retrieved from www.hallway.org Gerdil, C. (2002) The Annual Production Cycle for Influenza Vaccine. Vaccine. Vol. 21, 1776-1779. Herrick, D. (2004 Oct. 28) What’s Behind the Flu Vaccine Shortage. National Center for Policy Analysis. No. 493. Orenstein, W. & Schaffner, W. (2008) Lessons Learned: Role of Influenza Vaccine Production, Distribution, Supply, and Demand—What It Means for the Provider. The American Journal of Medicine. Vol. 121, S22–S27. Preparation for Pandemic: Influenza A H1N1. (2009 May 8). The Lancet – Leading Edge. Vol. 9, June 2009. Putting Influenza H1N1 in its Place. (2009 May 8). The Lancet – Leading Edge. Vol. 9, June 2009. Osterholm, M. (2005) Preparing for the Next Pandemic. The New England Journal of Medicine. May 5, 2005. Vol. 352, Iss. 18. Yoo, B., Kasajima, M., Fiscella, K., Bennet, N., Phelps, C., Szilagyi, P. (2009) Effects of an Ongoing Epidemic on the Annual Influenza Vaccination Rate and Vaccination Timing Among the Medicare Elderly: 2000-2005. American Journal of Public Health. Suppliment 2, 2009, Vol. 99, No. S2.