Vaccines program review pushed

March 04, 2020
Department of Health

DOH considers new WHO-PCV findings; health advocates laud move.

THE Department of Health (DOH) said in a recent statement that in light of new 2017 and 2019 evidence from global health experts, it requested the Health Technology Assessment Council (HTAC) to review the National Immunization Program (NIP), particularly the Pneumococcal Vaccination Program for children.

“Under the UHC law, the HTAC is mandated to review existing health programs and benefits of the DOH and PhilHealth in the next two years. The DOH, therefore, asked the HTAC to review the PCV (Pneumococcal Conjugate Vaccines) in light of scientific evidence and the significant budget impact of this particular vaccine to the department.” Secretary Duque said in the statement.

The DOH statement also noted that the DOH is holding off the procurement of any PCV while waiting for HTAC to complete its assessment.

This move supersedes the DOH’s PCV review conducted in 2014.

In 2017, the World Health Organization, after a systematic literature review, stated: “There is at present no evidence of different net impact on overall disease burden between the two products.”  

Then, in February 2019, WHO reaffirmed this earlier position saying that the two available PCVs are equally effective in preventing overall pneumococcal diseases in children. The position paper also states that there is at present insufficient evidence of a difference in the net impact of the two available PCVs on overall disease burden.

This move of the Secretary Duque and the DOH to have the tender and procurement of PCVs reviewed was lauded by vaccine experts and health advocates.

Former Bulacan governor and current chairman of the Medicines Transparency Alliance (MeTA) Obet Pagdanganan noted in a recent interview, “I support the DOH move to suspend the procurement of PCVs until the HTAC has completed its evaluation on the budget impact and evidence-based suitability of the two vaccines to deliver the desired health outcomes to the Filipino people.”

Pagdanganan echoed what he said during a previous panel of health experts and advocates. In a panel discussion entitled, “The Need for Transparency and Truthfulness in Public Health Amid Misinformation and Fake News” at the Manila Hotel early this month, Pagdanganan also referred to the new WHO findings that show the equal efficacy of PCV-10 and PCV-13.

“I support the idea that these vaccines should undergo the review of HTAC. We have advocated for the HTA process under the Universal Health Care law to ensure evidenced-based interventions,” Paula Tanquieng of advocacy group Ayus na Gamot sa Abot Kayang Presyo (AGAP) Coalition declared in a statement.

“We just hope that the process will not take too long to complete so as not to hinder the continuous provision for this important vaccine. The action of DOH is simply in accordance with the UHC law, I believe. Whether PCV 10 or 13 is best, I leave to the findings of experts in the HTAC. We just note that it must be emphasized that HTAC checks most cost effective, among others,” Tanquieng added.

“It’s always best to have a public bidding, because competition will give you the best price. It is transparent,” noted Tom Syquija, former Executive Director of Procurement Service- Philippine Government Electronic Procurement System (PS-PhilGEPS). “You get the same quality but at the lowest price. It’s always best for the public if you have competition.”

Parenting advocate and media personality Niña Corpus also lauded the DOH’s move to review the PCV tender, citing concerns of parents who need the freedom to choose their vaccines.

“I support the DOH move because we’re looking at the overall impact of the PCV that will eventually be chosen by the government and what will benefit more Filipinos given that both vaccines have been proven comparable,” Corpus said. “This is my reaction not just as a parent but a health advocate, journalist, and the host of health show Reseta ni Dok on DZMM’s Good Vibes.”

The DOH recently said that the deferment of bidding for PCVs will not affect the supply situation. Undersecretary Eric Domingo in a recent interview said that current supplies are still enough until the middle of the year.

In an earlier forum, Dr. Lulu Bravo, Executive Director of the Philippine Foundation for Vaccination (PFV), stressed that saying that one vaccine is weaker than the other is misleading and contributes only to misinformation.

“The people need to rely on what independent global experts say because it is our responsibility, as pediatricians, to be updated with the most relevant, and most updated information,” Bravo stressed. “Our basis should be the global health experts, such as the World Health Organization who, in a more recent study, stated that PCV13 and PCV10 are comparable in performance and impact.”

The WHO’s stand on the comparability of the two PCVs is backed by other global health experts, such as the Pan-American Health Organization (PAHO) and the international Vaccine Access Center (IVAC).

In its own review of the evidence of the impact and effectiveness of PCV, PAHO said that available evidence to date indicates the significant impact of both PCV10 and PCV13 in the outcomes studied, with no evidence of the superiority of one vaccine over the other on pneumonia, Invasive Pneumococcal Diseases (IPD), or meningitis hospitalization reduction in children under five years old.

The IVAC, in their 2017 PCV product assessment which was based on a comprehensive review of published data, also declared that current evidence does not indicate an added benefit with one vaccine over the other.