Abstract
Payment for vaccines appears, from recent shortages, to have been inadequate. This paper addresses the roles of various stakeholders in influencing current payment and affecting possible increases. It is argued that the recent problems may have stemmed from undervaluation by government payer-negotiators, by private insurers, and ultimately by consumers themselves. On the supply side, the high profits available to other kinds of drug-firm investments may have inhibited allocation of resources to development of new vaccines, and the low profitability and near-monopoly status of current products may have produced insufficient incentives for producers to protect supply against accidents.

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