Apples and oranges? Can second generation vaccines become as low cost as generic medicines?

The recent approval of multiple new vaccines and their introduction in many Gavi countries have been the impetus for efforts to reduce the costs of these vaccines. In this paper, we provide an overview of the main cost drivers for bringing second generation vaccines and compares these, where relevant, to the cost of bringing generic medicines to market. We argue that the main cost drivers for vaccine development are fixed, implying that second-generation vaccines do not lead to the same price reduction as normally seen with generic drugs. Lastly, we provide recommendations of the areas within vaccine development that could support further cost reductions.