Forecasting demand and return on investment for a trivalent Salmonella vaccine for children in sub-Saharan Africa

Abstract While a growing number of invasive non-typhoidal Salmonella (iNTS) vaccine candidates, including trivalent formulations with typhoid conjugate vaccine (TCV), are in early development, the market demand and commercial potential remain unclear. This study presents a novel demand and financial forecast model for a hypothetical trivalent iNTS-typhoid vaccine, designed for introduction in sub-Saharan Africa (sSA). The model includes projected vaccine demand, revenue and profit forecasts, and net present value (NPV) analysis of return on investments required for development, licensure and manufacturing of the trivalent vaccine. By year 12 after forecasted introduction, annual demand for the trivalent vaccine is projected to reach 47 million doses for a 1-dose regimen and 96 million doses for a 2-dose regimen (Scenario 2), generating annual revenues of $94 million USD and $191 million USD, respectively. Despite these projections, the risk-adjusted NPV is negative, suggesting that the market is not commercially viable for industry investment without global health funding to de-risk the investment. This model assumes a significant demand for a trivalent vaccine in sSA and highlights the need for innovative financing to ensure commercial viability of investment in the vaccine’s development and manufacturing, toward addressing a significant public health issue.