Price of prevention

An interesting take on how Vaccines once considered a poor business prospect has seen rising costs. The articles aligns with the cost conundrum in Healthcare, similar to the different cases of the Paying Till It Hurts series, focuses on how "Prevention is better than cure" has been capitalized. A simple example to understand the magnitude of increase in cost - over the last 3 decades, the co-pay involved for an individual until the age of 18 has risen from $100 to $2,200.

The article offers three perspectives -

• Care Providers through the eyes of Dr. Lindsay Irvin
• The society being represented by the Farris family
• And the viewpoint of vaccines with Prevnar, pneumonococcal vaccine from Pfizer

Touching briefly on the first two perspectives, the increased costs of vaccines have made it difficult to both providers and the public. Many physicians have stopped administering immunizations due to losses incurred involving the expensive vaccines. This leads to a stress on the public, where vaccination is mandated for children entering schools, and families find it difficult to locate the few practitioners who still administer vaccines.

Finally the story of Prenvar gives an overview of the cost conundrum. Though components of the vaccine do not change, the price continue to rise through the years for no apparent reason. There are pointers which are offered as an explanation by pharmaceuticals organization which include the investment into the R&D, larger clinical trial requirement, requirement of approval of FDA and another federal committee - Advisory Committee on Immunization Practices, and reviews which paint, if not biased, an uneven positive economic benefits of the vaccine. Nonetheless the justification of high price does not justify the continued soaring cost.

A personal opinion, probably harsher that this case presents, I would say that the profit mongering pharmaceutical industry need to look beyond the cost vs. benefit proposition and see the effect on the both Care Providers and the public.

This opinion is vindicated partially by the follow-up article on the availability of Crucial Vaccines. From elimination of Smallpox and control of Polio to business case for vaccine entry into a particular shows the skewed trajectory of our progress. The article captures the hurdles presented by the US healthcare system for vaccine entry from other countries. 2010 - 2013 breakout of a particular strain of Meningitis with vaccine availability only outside the US, led to CDC and FDA to introspect its process. The expensive and at times politically challenged nature of drug approval has allowed to pharmaceutical industry to flourish outside the US.

It is time that the healthcare industry, not with respect to vaccine alone, realize the impending the financial stress on the society driven by the soaring costs of medicine.