Combination vaccine price in China

1) Procurement price

The procurement price of pediatric combination vaccines in China exceeds the global average. Taking the prices of non-NIP vaccines in 2022 Shanghai procurement as an example, the domestically produced DTaP-Hib pre-filled quadrivalent vaccine has replaced the vial quadrivalent vaccine, compared with the procurement winning bid list of 2019. The new quadrivalent vaccine won the bid for 368 CNY per dose, while the imported pentavalent vaccine’s winning bid price was 599 CNY per dose¹. In June 2023, the Chongqing Municipality Government publicized group procurement results for non-NIP vaccines in 2023; the price of one dose of imported pentavalent vaccine (0.5ml) was 638 CNY².

2022 Shanghai non-NIP vaccine group procurement winning catalog

Product Name	Unit	Packaging	Vaccine Marketing Authorization Holder	Price CNY/pc
DTaP-Hib (Quadrivalent)	0.5ml	Prefilled syringe	Beijing Minhai Biotechnology Co. Ltd.	368
DTaP-IPV/Hib (Pentavalent)	0.5ml	Vial and prefilled syringe	Sanofi Pasteur	599

Data source: http://www.shgpo.com/jggb/858.jhtml

2) Prices of pentavalent vaccine at sampled institutions in 2020 (By Province)

According to the Chinese National Healthcare Commission’s Health Development Research Center (NHDRC), in 2020, the average price of DTaP-IPV/Hib pentavalent vaccine in sampled institutions nationwide was 619.47 CNY per dose. By region, the eastern region had the lowest average price at 616.66 CNY per dose, followed by the central region at 622.07 CNY per dose. The pentavalent vaccine had the highest average price in the western region among the sampled institutions, at 624.37 CNY per dose.

Province (Municipality and Autonomous Region)	Average Price (CNY/dose)	Province (Municipality and Autonomous Region)	Average Price (CNY/dose)
Beijing	612.3	Shandong	622.87
Tianjin	614.9	He’nan	620.91
Anhui	631.48	Hubei	623.23
Shaanxi	616.6	Hunan	621.08
Inner Mongolia	no vaccine administered	Guangdong	619.63
Liaoning	617.46	Guangxi	627.75
Jilin	611.24	Hainan	614.79
Heilongjiang	607.01	Chongqing	618.85
Jiangsu	602.57	Guizhou	627.41
Zhejiang	614.69	Yunnan	618.37
Anhui	627.31	Shaanxi	634.02
Fujian	611.24	Gansu	613.36
Jiangxi	620.31	Qinghai	619.18

Source: NHDRC

3) Prices of Pentavalent vaccine in 2020 at sampled healthcare facilities (By facility type)

NHDRC Data of 2020 showed that different healthcare facilities’ prices of pentavalent vaccines varied. Ranked from the highest to the lowest price, the facilities where people received pentavalent vaccines were family planning technical service centers, CDCs, Chinese medicine hospitals/Chinese-Western medicine hospitals, general hospitals, specialized hospitals, maternal and child health clinics/hospitals, community health service centers, and township health centers.

Type of healthcare facilities	Average price (CNY/dose)
General hospital	620.31
Chinese medicine hospital/Chinese-Western medicine hospital	621.45
Specialized hospital	620.00
Community health service center	618.47
Township health center	618.33
Center for disease control and prevention (CDC)	625.59
Maternal and child health hospitals/clinics	619.83
Family planning technical service center	626.06

Source: NHDRC

(4) Prices of pentavalent vaccine at sampled institutions in 2020 (By legal entity type)

NHDRC Data disclosed that the pentavalent vaccine price in non-profit healthcare entities was higher than that in profit-oriented healthcare facilities. The average price difference was around 7 CNY per dose.

Nature of Organization	Average price (Yuan/dose)
Non-profit	619.58
Profit-oriented	612.39

Source: NHDRC

Combination vaccine financing in China

In China, the combination vaccines are mainly relied on out-of-pocket payment. Some regions have actively explored innovative financing methods for non-NIP vaccines, such as including them in the health insurance coverage³. For example, in April 2018, the Shenzhen Municipal Bureau of Human Resources and Social Security issued a Notice of Including the Catalog of Preventive Vaccination Biological Products into the Coverage of Individual Accounts for Medical Insurance (Revised in 2018), which revised and updated the 2011 version, expanding the 28 types of preventive vaccination biological products to 36 types.   Among the additional eight biological products was the DTaP-IPV/Hib pentavalent vaccine ⁴. However, the newly revised “Shenzhen Medical Security Measures” in September 2023, specifically Article 47, clarified that medical expenses that public health projects should cover are not included in the scope of payment coverage of the basic medical insurance⁵.

Combination vaccine procurement model in China

At the provincial level, provincial government agencies initiate the procurement of non-NIP vaccines. Usually, the first-round selection of non-NIP vaccine products is initiated by provincial-level CDCs, resulting in a recommended catalog of non-NIP vaccines. Vaccines that meet the qualification criteria are then entered into the public resource trading platform. Then, the district (county)–level CDCs organize a secondary selection process based on local demand, placing the orders among the available vaccine lists.

There are two principles that the non-NIP selection process needs to follow: 1) First, vaccine manufacturers must meet specific qualification standards and be approved to list their products on the provincial public resource trading platform. The catalog of vaccine types is often compiled with reference to those of other provinces (autonomous regions and municipalities) directly; 2) second, the procurement prices are compared with other relevant provinces (autonomous regions and municipalities), with the requirements such as the price be the lowest among them to be included in the catalog⁶.

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Content Editor: Menglu Jiang

Page Editor: Ziqi Liu

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References

1. 2022 Shanghai Non-Immunization Program Vaccine Group Procurement Project Awarded Bids Announcement (Second Batch). http://www.shgpo.com/jggb/858.jhtml

2. Chongqing Non-Immunization Program Vaccine 2023 Centralized Procurement Quotation Results Public Notice. https://www.yjsds.com/web/article/1184245245449408512/web/content_1184245245449408512.html

3. Peng QB et al. Current status of influenza vaccine application in China and policy discussion on promotion of vaccination. Chinese Journal of Epidemiology. 2018, 39(8): 1045-1050

4. Shenzhen Human Resources and Social Security Bureau. Policy Interpretation on the Catalog of Prophylactic Biological Products Included in the Scope of Payment by Health Insurance Individual Accounts (2018 Revision). http://hrss.sz.gov.cn/xxgk/zcfgjjd/yfswzpmldzcjd/.

5. Shenzhen Municipal People’s Government Decree (No. 358) Shenzhen Medical Security Measures. https://www.sz.gov.cn/gkmlpt/content/10/10826/mpost_10826875.html#748

6. Li Mengying, Li Xinghui, Fu Chaowei, et al. “Effective Selection of Non-Immunization Program Vaccines: The Bidding Procurement System Needs Further Optimization.” Chinese Health Resources, 2020, 23(6): 604-607. DOI: 10.13688/j.cnki.chr.2020.20319