Covid-19 vaccine market to be worth $6 billion in India: Bernstein

"If the government chose to vaccinate the entire population, they would need to set aside an additional $6 billion. This would imply an almost 100% increase to the current Central Government Healthcare budget," Bernstein analyst Nithya Balasubramanian said in a report.

Balasubramanian took, what she believes is a more realistic approach, assuming that the government would immunise only 30% of India’s roughly 1.3 billion population, or 390 million, with two doses while the rest will have to buy to the private market. She estimated the price of the vaccine at $3 per dose for government procurement and $6 for the private market.

The $3 per dose price was also agreed by Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation with Serum Institute of India for producing up to 100 million for supply to India and other low- and middle-income countries.

To cover 340 million people with two doses each, the government will require almost three years, with around 31 immunisation cycles, the report estimated based on current immunisations programmes.

"The throughput can of course be increased but cold chain storage facilities and manpower (ASHA workers, ANMs and other last mile delivery support workers) will prove to be bottlenecks. Having worked on public-private-partnership models in my earlier life, I can say with confidence that manpower will be the largest bottleneck to faster implementation," Balasubramanian, a former Cipla executive, said in the report.

Currently, India has three vaccines under human trials. Serum Institute of India is the frontrunner, having started a parallel phase 2 and 3 trial of a adenovirus-based vaccine candidate that was co-developed by University of Oxford and Astrazeneca plc. Serum Institute had signed an agreement in June with Astrazeneca to supply 1 billion doses of the vaccine to low- and middle-income countries. The phase 3 trials are expected to complete by the end of this year.

The other two vaccines are indigenous—one is a wholly-inactivated vaccine being co-developed by Bharat Biotech International Ltd and Indian Council of Medical Research’s National Institute of Virology in Pune, and another is a DNA plasmid by Zydus Cadila Ltd. Both are in parallel phase 1 and 2 trials. Both the vaccines are expected to be launched early next year.

There are another three to four vaccines which are in pre-clinical trials, like Gennova Biopharmaceuticals’ latest-generation mRNA vaccine, Panacea Biotec’s wholly-inactivated vaccine and India Immunologicals’ attenuated virus vaccine.

Biological E is also in a pact with Johnson & Johnson to mass manufacture the US-based company’s vaccine, which is currently in phase 1 and 2 trial.

Vaccine trials usually take 10-12 years, but considering the emergency situation, these have been world-over shortened to a record time of about 10-12 months since the virus came into limelight in the last week of December 2019. This shortening of timeline has been done by conducting parallel phases and a smaller number of participants, while conducting the safety studies over the entire duration of the trial.