全球疫苗集中采购的价格效应

doi:10.19723/j.issn.1671-167X.2026.03.001

Abstract

Abstract:

Objective: To evaluate the impact of international pooled procurement mechanisms, which are primarily represented by the United Nations Children ' s Fund (UNICEF) and the Pan American Health Organization (PAHO), on the procurement prices of vaccines. Methods: Based on 14 497 vaccine procurement transaction records collected from 188 different countries spanning the period from 2013 to 2024, this research employed a high-dimensional fixed effects model along with an event study metho-dology to accurately identify the price effects and dynamic temporal trends, while simultaneously conducting a multidimensional heterogeneity analysis. Results: (1) The baseline model demonstrated that, when compared to the independent self-procurement conducted by individual nations, utilizing pooled procurement through the UNICEF significantly reduced the average vaccine prices by 27.6% (β=-0.323, P < 0.01). The PAHO mechanism similarly exhibited an initial price reduction potential of approximately 30.9% (β=-0.370, P=0.052). (2) The event study method strictly validated the parallel trend assumption (joint significance test of pre-treatment coefficients: F=0.27, P=0.845). Dynamic tracking revealed that a price reduction of approximately 30.0% (β=-0.356, P < 0.01) was achieved exactly in the year of transitioning from self-procurement to pooled procurement, and this reduction effect remained persistently stable in subsequent years. (3) Heterogeneity tests revealed a significant "pro-poor" effect of pooled procurement: the price reduction margin obtained by small-scale buyers (38.5%, β=-0.487, P < 0.01) was significantly higher than that of large-scale buyers (22.5%, β=-0.255, P < 0.01). The marginal price reduction coefficient for non-Global Alliance for Vaccines and Immunization (GAVI) eligible countries (β=-0.418, P < 0.01) was substantially larger than that for GAVI eligible countries (β=-0.118, P < 0.05). The high-income country group experienced the most substantial price drop (β=-0.475, P < 0.01). (4) The supply-side moderating effect analysis indicated that UNICEF' s collective bargaining power maintained robustness across diverse market structures, showing no statistically significant attenuation despite increases in market concentration (interaction term β=0.095, P>0.10). Conclusion: Institutionalized pooled procurement mechanisms are capable of significantly reducing vaccine prices. For those countries that are currently in the immunization financing transition period, as well as those facing high self-procurement benchmark prices, participating in an efficient international pooled procurement platform serves as a critical institutional arrangement to replace external financial aid and to effectively maintain the long-term affordability of vaccines.

Key words: Vaccines, Pooled procurement, Costs and cost analysis, Global health, Market structure

CLC Number:

R186

Yuxin HUANG, Xiaoyi YU, Ming XU. Price effects of global vaccine pooled procurement[J].Journal of Peking University (Health Sciences), 2026, 58(3): 437-445.

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References 25

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Vaccine	Other	Other pool-procurement	PAHO	Self-procurement	UNICEF	Total
BCG	18	3	176	385	683	1 265
Combination vaccines	147	45	1 084	2 386	2 427	6 089
HPV	21	5	136	258	221	641
Hepatitis B	37	12	313	713	451	1 526
Hib	15	3	38	192	10	258
Measles	2	0	0	74	253	329
Pneumococcal conjugate	36	4	124	415	596	1 175
Polio	29	15	387	464	1 542	2 437
Rotavirus	20	15	102	189	438	764
Rubella	1	0	0	12	0	13
Total	326	102	2 360	5 088	6 621	14 497

Items	Observations	Mean	SD	Minimum	Maximum
Price per dose (USD)	14 497	7.72	16.83	0.03	240.30
Transaction volume (doses)	14 497	1 578 766.53	8 827 643.06	1.00	5.56×10⁸
HHI (market concentration)	14 497	0.00	0.27	-0.45	0.55
Procurement: self-procurement (dummy)	14 497	0.35	0.48	0.00	1.00
Procurement: UNICEF (dummy)	14 497	0.46	0.50	0.00	1.00
Procurement: PAHO (dummy)	14 497	0.16	0.37	0.00	1.00
Procurement: other pool-procurement (dummy)	14 497	0.03	0.17	0.00	1.00
WHO PQ certified (yes=1)	14 497	0.73	0.44	0.00	1.00
GAVI eligible country (yes=1)	14 497	0.37	0.48	0.00	1.00
Income: high (dummy)	14 497	0.26	0.44	0.00	1.00
Income: upper-middle (dummy)	14 497	0.29	0.45	0.00	1.00
Income: lower-middle (dummy)	14 497	0.29	0.46	0.00	1.00
Income: low (dummy)	14 497	0.15	0.36	0.00	1.00

Items	Model 1 ln(price)	Model 2 ln(price)	Model 3 ln(price)	Model 4 ln(price)	Model 5 ln(price)
UNICEF SD, mean (SE)	-0.478 (0.082)^***	-0.487 (0.082)^***	-0.323 (0.074)^***	-0.285 (0.077)^***	-0.265 (0.075)^***
PAHO, mean (SE)	-0.528 (0.167)^***	-0.557 (0.168)^***	-0.370 (0.189)^*	-0.341 (0.231)	-0.280 (0.236)
Other pool-procurement, mean (SE)	-0.027 (0.136)	-0.042 (0.127)	0.207 (0.136)	0.486 (0.133)^***	0.542 (0.136)^***
Other, mean (SE)	0.168 (0.083)^**	0.137 (0.084)	0.109 (0.086)	0.005 (0.112)	0.026 (0.108)
ln(volume), mean (SE)		-0.061 (0.008)^***	-0.027 (0.007)^***	-0.021 (0.007)^***	-0.018 (0.007)^**
WHO PQ certified, mean (SE)	-0.024 (0.057)	-0.025 (0.056)	-0.065 (0.028)^**	-0.037 (0.026)	-0.048 (0.045)
Country FE	Yes	Yes	Absorbed	Absorbed	Absorbed
Product FE	Yes	Yes	Absorbed	Absorbed	Absorbed
Year FE	Yes	Yes	Yes	Absorbed	Absorbed
Country-product FE	No	No	Yes	Yes	Yes
Product-year FE	No	No	No	Yes	Yes
Country-year FE	No	No	No	Yes	Yes
Manufacturer FE	No	No	No	No	Yes
Observations	14 269	14 269	13 081	12 675	12 439
R-squared	0.929	0.930	0.969	0.982	0.982

Items	Baseline	Buyer size		GAVI eligibility		Income group
Items	Baseline	Small buyer	Large buyer	GAVI	Non-GAVI	LIC	LMIC	UMIC	HIC
Other, mean (SE)	0.109 (0.086)	0.040 (0.063)	0.116 (0.125)	0.060 (0.099)	0.124 (0.098)	-0.528 (0.300)^*	0.025 (0.107)	0.335 (0.221)	0.063 (0.055)
Other pool-procurement, mean (SE)	0.207 (0.136)	0.343 (0.182)^*	0.304 (0.222)	0.453 (0.187)^**	0.201 (0.139)		0.252 (0.176)	0.203 (0.136)
PAHO, mean (SE)	-0.370 (0.189)^*	-0.379 (0.276)	-0.340 (0.190)^*	-0.134 (0.061)^**	-0.616 (0.351)^*	-0.268 (0.292)	-0.256 (0.118)^**	-0.185 (0.220)	-1.222 (0.267)^***
UNICEF SD, mean (SE)	-0.323 (0.074)^***	-0.487 (0.130)^***	-0.255 (0.072)^***	-0.118 (0.048)^**	-0.418 (0.093)^***	-0.311 (0.289)	-0.288 (0.108)^***	-0.386 (0.086)^***	-0.475 (0.073)^***
ln(volume), mean (SE)	-0.027 (0.007)^***	-0.052 (0.014)^***	-0.010 (0.009)	-0.002 (0.005)	-0.038 (0.011)^***	0.002 (0.007)	-0.017 (0.008)^**	-0.040 (0.016)^**	-0.036 (0.017)^**
n	13 081	5 681	6 959	4 987	8 033	1 963	3 847	3 565	3 336

	Baseline	HHI interaction	PQ interaction
UNICEF SD, mean (SE)	-0.323 (0.074)^***	-0.317 (0.073)^***	-0.381 (0.104)^***
PAHO, mean (SE)	-0.370 (0.189)^*	-0.357 (0.189)^*	-0.376 (0.179)^**
Other pool-procurement, mean (SE)	0.207 (0.136)	0.202 (0.138)	0.459 (0.200)^**
Other, mean (SE)	0.109 (0.086)	0.124 (0.092)	0.067 (0.076)
ln(volume), mean (SE)	-0.027 (0.007)^***	-0.027 (0.007)^***	-0.027 (0.007)^***
WHO PQ certified, mean (SE)	-0.065 (0.028)^**	-0.064 (0.028)^**	-0.098 (0.045)^**
HHI (centered), mean (SE)		-0.038 (0.074)
UNICEF×HHI, mean (SE)		0.095 (0.140)
UNICEF×PQ certified, mean (SE)			0.069 (0.074)
Country-product FE	Yes	Yes	Yes
Year FE	Yes	Yes	Yes
Observations	13 081	13 081	13 081
R-squared	0.969	0.969	0.969

Price effects of global vaccine pooled procurement

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