The commercial landscape for infectious disease vaccines.

Vaccines, while having a huge impact on human health in both industrialized and developing countries, account for a small fraction of biopharmaceutical industry sales.

Just 3.5% ($28 billion) of worldwide prescription drug sales were from vaccines in 2017. This increased to about $37 billion in 2018.

The vaccine market is also highly concentrated. In the 1960s over two dozen companies manufactured vaccines. Today, four companies — GlaxoSmithKline, Merck & Co., Pfizer and Sanofi Pasteur — account for about 90% of worldwide sales in dollars. For phase II programmes and later, just eight pharmaceutical companies account for most of the development pipeline.

As of December 2018, @NatRevDrugDisc identified 132 vaccine development programmes that target 46 different infectious diseases. The four most common targets are influenza (16%; 21 candidates), HIV (12%; 16 candidates), respiratory syncytial virus (7%; 9 candidates) and Ebola virus (6%; 8 candidates).

Even among the ‘big four’ companies, vaccines comprise only 11–17% of their worldwide sales, making them important but not dominant business-units internally. The barriers to entry that have maintained these big four companies’ combined market share over decades include the large capital costs and highly specialized personnel required to build and operate vaccine manufacturing facilities. 

Drug manufacturers worldwide are working relentlessly on a vaccine for COVID-19. While each collaboration faces its own set of challenges, all agree now is the time for a radical rethink on the discovery and development process for pandemics