Competition among pharmaceutical and biotech companies with influenza (flu) vaccines is intensifying more than ever.

As more and more companies, including global pharmaceutical companies, are seeking to supply vaccines on-site, and specialized vaccines are being launched for each age group, the competition is expected to be unprecedented this autumn.

# In particular, the formation of a non-reimbursed market for both vaccines has become a hot topic in the field, especially in the context of the resurgence of COVID-19.

However, industry insiders do not expect large-scale co-vaccination to be carried out among adults, except for high-risk patients who are eligible for the National Immunization Program (NIP).

According to industry sources on the 7th, the vaccine contracted by the Korea Disease Control and Prevention Agency (KDCA) for the ‘2024-2025 Influenza NIP Project’ is 11.7 million doses worth KRW 12.9 billion. This is more than the previous year's contracted volume of 11.21 million doses.

KDCA signed contracts with GC Biopharma, Sanofi, Boryung Biopharma, SK Bioscience, Korea Vaccine, and Il-Yang Pharmaceutical. This is similar to last year.

However, the details are different. Last year, GC Biopharma supplied less than planned after making the highest bid through the NIP, but the company made a different choice this time.

Last year, GC Biopharma bid to supply 4.3 million doses, but only 1.74 million doses were delivered through NIP due to its supply price being pushed back.

In other words, the doses that the company was unable to supply through the NIP were released into the non-reimbursed adult vaccine market.

But the situation was different this year. GC BIopharma bid the highest price for the NIP, at KRW 10,810 per vaccine, and the largest volume of 2.65 million doses. The company was followed by SK Bioscience, which bid KRW 10,470 per vaccine for 2.55 million doses.

It is also worth noting that Sanofi, which bid the lowest price at KRW 10,340, will supply 2.15 million doses. In addition, Il-Yang Pharmaceutical and Korea Vaccine will supply 2 million doses and Boryung Biopharma will supply 1.25 million doses to NIP.

In addition, GSK will supply the flu vaccine Fluarix Tetra for the pediatric NIP. As a result, most of the flu vaccines are included in the NIP.

The difference this year is in the adult vaccine market for the elderly.

This is because Sanofi is planning to launch ‘Efluelda,’ a high-dose influenza vaccine for people aged 65 and over in time for this year's flu season in addition to the existing Vaxigrip.

It is worth noting that CSL Seqirus launched ‘Fluad Quad’ last year for the 65+ age group. Fluad Quad was the first vaccine to enter this market, but the subsequent entry of Efluelda has created competition in the non-reimbursement vaccine market for the 65+ age group.

While the NIP includes people aged 65 and older, clinical sites say there is a clear market for non-reimbursed Fluad Quad given the vaccination experience last year.

“Given the situation last year, 1 in 10 of the elderly sought the vaccine,” said an otolaryngologist who requested anonymity. “I brought in about 100 units, which I used with the 1,200 doses of the NIP vaccine. I think the point that it is particularly effective for those aged 65 and older has made them aware of the need.”

“Last year, the price of the vaccine was KRW 40,000 to 50,000, but this year, we need to consider the entry of its competitor,” he said. “There may be differences by region, but the price of the general vaccine is likely to be between KRW 25,000 and 30,000, and the price of the vaccine for the elderly is likely to set KRW 10,000 higher.’

Another point of interest is how the reemergence of COVID-19 will affect the flu vaccination season later this year.

According to KDCA, 837 hospitalized patients were reported in the COVID-19 sentinel surveillance report at Week 35, a 28.0% decrease from Week 34 (1,163). This is a 48.2% decrease compared to Week 33 (1,464), 2 weeks earlier. The pathogen detection rate has also been decreasing for 2 consecutive weeks, from Week 33 (43.4%) to Week 34 (39.0%) to Week 35 (34.0%).

COVID-19 viral concentrations in the wastewater surveillance also decreased by 27% from 2 weeks ago.

While it is believed that the peak of the pandemic has passed, the government plans to continue to support COVID-19 vaccinations for high-risk groups, including those aged 65 and older and those who are immunocompromised.

The clinical field is interested in the volume of non-reimbursed COVID-19 vaccinations alongside the flu vaccinations. If interest continues to rise, the patients may inquire about COVID-19 vaccinations during the flu vaccination season.

In this situation, Moderna Korea, a leading vaccine supplier, has ended its relationship with Kwangdong Pharmaceutical and entered into a strategic partnership with Boryung Biopharma for the supply of COVID-19 vaccines in Korea.

Through the partnership, Boryung Biopharma will provide medical information on Moderna's updated COVID-19 vaccine, which will be used in the government's ‘2024-2025 Season Inoculation Program,’ to healthcare providers in Korea.

However, it is unlikely that many adults will be vaccinated with the non-reimbursed COVID-19 vaccine as it is relatively expensive. Currently, there is a consensus that the vaccine price will be in the mid-KRW 100,000 range without reimbursement.

“The government seems to want to support COVID-19 vaccines to high-risk groups such as the elderly over the age of 65. Some of the other COVID-19 vaccines are currently in supply and their purchase price is in the KRW 100,000 range,” said Kyung-Geun Kwak, Chair of Seoul Physician’s Association (Seoul Medical Clinic) ”Because of this, the price of the COVID-19 vaccination will be in the mid- KRW 100,000 range. The flu had spread in Korea from August to September along with COVID-19, so those who had suffered inconvenience due to the 2 may likely seek vaccination for either disease.”

Kwak added, “I understand that there are global policies in place, but personally I believe the COVID-19 vaccine is too expensive. “I doubt that relatively younger patients, except for high-risk groups, would be willing to receive vaccination at the price.”