Innovation Incentives for Health Emergencies Vaccine Development

Economic incentives stimulate innovation and new vaccines and drugs development are crucial to meet future pandemics.  By rigorous modelling of data from governmental bodies, pharmaceuticals researchers, companies and epidemiological sources, we provide analytically based policy solutions to efficient, targeted and commercially viable incentives that can be responsive to health emergencies.

Jonathan Liebenau, PhD

Reader in Technology Management

London School of Economics

Vaccine development has been disproportionately disincentivized, a critical failing of allocative efficiency that has to be rectified for future health emergencies. Since the beginning of 2020 billions have been spent on COVID-19 vaccines and drug developments, repurposing existing medications and related activities such as pre-purchase agreements. These need to be evaluated to ensure that spending is efficient ahead of future health emergencies. Better outcomes could also emerge from incentives distributed to developing countries.

This underfunding of vaccine innovation has been aggravated by a piecemeal approach to health innovation, including efforts such as the "orphan drug" schemes offering a myriad of tax incentives, direct grants and indirect subsidies, regulatory conditions and procedural practices that minimise R&D risk in niche patient populations and fail to prepare us for large-scale health emergencies.

The speed of development and distribution has a direct effect on the morbidity and mortality of people worldwide.  The cost and indirect effects upon health systems, the pharmaceutical industry and national economies are hugely damaging.

Our solutions will guide policy makers, manufacturers and others towards better economic choices, more effective use of resources associated with medicines development and more rapid and equitable outcomes to health emergencies.

The primary audience is policy makers responsible for public health, drugs regulation, high technology businesses, etc.  The key secondary audience is pharmaceutical company executives, industry associations, NGOs and research strategists.  Others include health economists, investment advisors and business development specialists.  

• Public health innovation funding agencies and donors
  • To assist in identifying effective ways of allocating funds for health emergencies
• Multilateral organisations coordinating funding and regulation e.g. the WHO, plus vaccine purchasers, e.g. GAVI, COVAX and national health authorities
  • To assist in promoting innovations most likely to yield approved vaccine products.
• Pharmaceutical industry
  • To support efforts to make best use of drugs development capabilities in commercially viable ways by briefings for companies and industry associations. 
• Regulatory bodies
  • By showing effects of regulatory forbearance and special conditions enacted in health emergencies.
• Tax authorities
  • By showing the relative efficacy and systemic costs of differing applications of tax incentives for drugs development. We will demonstrate how such costly measures can be used efficiently. 
• National and international policy makers, including legislators
  • We will compare international costs and outcomes and show how policies can better be drafted, enacted and enforced. 

Incentivising preparedness innovation ensures that all people are best served in advance of health emergencies by those responsible for developing and deploying responses. It promises that resources are allocated efficiently and sustainably, ahead of time, rather than under conditions of panicked speed and strain at great cost to lives.  Creating a global, evidence-based model will also clarify policies by incentivising vaccines or drug development for the public good. 

In applying these solutions in developed countries and adapting solutions for country-specific conditions, we also aim to assist developing countries to strengthen local capabilities by maximising the efficacy of incentive systems for their local as well as our worldwide community. 

We will be able to show how best to fund for general purpose technologies such as mRNA technologies and prioritising R&D in vaccines for other very high impact causes of health emergencies such as the COVID-19 pandemic and additional rare but lethal infectious diseases.

Our solutions aid public good firstly through delivering evidence-based responses relevant throughout the world and secondly by helping low and medium income countries to build more resilient systems taking account of their local conditions. 

Our tangible impact will be to draw investment to therapeutic areas relevant to health emergencies at lower cost. Our approach will reduce risk for vaccine innovators while minimising the cost for funders leading to better vaccine development outcomes. The result of our solution will be more vaccines and other drugs available on the market for use in response to health emergencies.

We will see this impact initially in changes in legislation and policy directives and in shifts in company strategies. Further in time, we will see this impact through increased investment in vaccine R&D.  Eventually, the impact will be measured as growth in the annual number of vaccines being approved and moving to markets where better health outcomes will be enjoyed.

The  early results of our analysis that assess the efficacy of tax incentives and regulatory forbearance will initially be disseminated through blogs, academic seminars and conferences. We will additionally provide briefings to public health policy groups, vaccine research funders (including CEPI, Gates Foundation, Wellcome Trust), international bodies (WHO), global vaccine distributors (GAVI, COVAX), government bodies of major vaccine R&D countries (US, EU, UK) and other countries with pharmaceutical manufacturing (esp. China, India, Russia, Japan). To model and test scenarios we will work with governments, companies and industry associations. We go beyond the focus on priority pathogens of pandemic potential and model vaccine innovation that has the potential to address other major health threats such as antimicrobial resistance. 

For our solution to scale, we will begin by running analytics on data based on US, UK, EU and Japan, as these are foundational countries with deep datasets already. With the underlying assets developed for our model, we will apply this to low and medium income countries. While inputting for local regulatory factors and general barriers, we will utilise our model to generate policy recommendations for such nations to help themselves build more resilient systems.

The ultimate output will be changes to vaccines development incentive schemes and regulatory practices that foster public health and especially health emergency treatment goals. This will in the long run mean a wider and more effectively targeted, and less expensive, vaccine capability. 

Interim measures include: new legislative proposals e.g. for tax incentives, changed strategic planning of vaccines developers and R&D funders, inclusion of our model for efficient resource allocation into WHO recommendations and into streamlining regulatory approval protocols.

Long term measures include: increased percentage of R&D spending on high priority pathogens of pandemic potential, more and better timed clinical trials for vaccines, an increase in the number of approved vaccines available for health emergencies. 

Access to data from companies is always difficult and we must find ways to overcome this through negotiations (using, for example, non-disclosure agreements) and finding proxies for available data, such as estimates of employees' skills as a proxy of R&D engagement.  Similarly, access to corporate executives is important and difficult to achieve but we have plans to use "snowball" methods to enlarge our sample and by being present at industrial conferences and other events, offering briefings on our progress and on the use of our tools, etc. Our collaboration with GSK is a starting point for that, as well as other existing contacts held by members of our team.

We cannot accurately predict our access to policy makers but we believe The Trinity Challenge will be of considerable help.  It will also assist us in reaching out to multilateral bodies.

London School of Economics and Political Science (Jonathan Liebenau, Biao Huang)

St George’s Medical School, University of London (Daniel Yim)

IQVIA (Chloé Hogg. NOTE: they are not providing any data or support in any form to the project)

University Medical Center Groningen (Sabrina Wimmer)

TTC offers the opportunity to implement our approach in a way that accelerates what might otherwise be a protracted, geographically limited, scholarly exercise. 

We believe that access to policy makers, multilateral organisations, NGOs, and public health bodies, in addition to pharmaceuticals manufacturers, will be greatly enhanced by assistance from TTC partners and boosted by the legitimating authority of TTC.  

We feel that as an academic group we will be much more limited in our opportunities to advocate for an implement our solution.  We also anticipate many advantages of being associated with other TTC projects, partners, advisors and associated individuals.

Our project's goal is to align with TTC's aim in creating a coalition of organisations to prepare the world better against future health emergencies using data-driven research and analytics.  Our contribution fits well with the challenge and provides us the opportunity to develop, deploy and scale our solution for the public good worldwide. 

We welcome contact and support from other members but will not specify them now.