In 2016, the Coalition for Epidemic Preparedness Innovations was established to develop vaccines in preparation for epidemic infectious diseases. The authors were interested in the minimum cost for achieving vaccine research and development preparedness targets in a portfolio of 11 epidemic infectious diseases. They examined a pipeline of 224 vaccine candidates covering preclinical through to phase 2 trials for 11 diseases. They modelled the cost of developing a single epidemic infectious disease vaccine from preclinical trials through to the end of phase 2a trials is US$31-68 million, assuming no risk of failure. The main upward drivers of research and development costs are previous licensure experience and indirect costs. When they accounted for the probability of success, the average cost of successfully advancing at least one epidemic infectious disease vaccine through to the end of phase 2a varies from US$84-112 million, when starting from phase 2, to $319-469 million, when starting from preclinical. This cost included the cumulative costs of failed vaccine candidates through the research and development process. If these vaccine candidates and funding are all available, progressing at least one vaccine through to the end of phase 2a for each of the 11 epidemic infectious diseases would cost a minimum of US$2·8-3·7 billion. Therefore there are significant funding needs and development gaps for achieving vaccine research and development preparedness targets.
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