“The Price of Prevention: Vaccine Costs Are Soaring” presents an interesting coverage on the pain of needle prick felt by the providers, policy makers, parents and of course neonatal alike. For few it is a pinprick pain of losing money on every single shot they give - providers; for few it is a pinprick pain brought by the frustration of their kids are being left deprived of life-saving vaccination - parents, and lastly for few other it is a pinprick pain felt by policy makers once their well-thought plans don’t produce effective results - the vaccine advisory committee.
In the USA, the cost of essential vaccination has increased steeply in last few years. Many clinicians have stopped providing the vaccination shots as they incur a loss for each shot they provide. In the article, a situation is illustrated for San Antonio, Texas where providers are facing an ethical dilemma associated with this peculiar issue. Providers know that it is absolutely imperative to provide the life-saving vaccination to the infants but it is a question of how much loss they can incur. Approximately 40% providers have stopped vaccinations as they are not profitable anymore which has certainly worsened the situations for consumers.
Many states recommend (if not mandate) vaccination like Prevnar before children can enter daycare or preschool. This recommendation has created a strong demand for vaccination in the market; and have allowed pharmaceutical companies to increase the costs. In a few cases, pharmaceutical companies patents a drug and hence monopolize the market. A specific example quoted in the article is of Prevnar 13 - a vaccination sold by Pfizer accounting to their $4 billion sales every year. Prevnar has no real competitor in US markets and courtesy to this fact, the price of Prevnar 13 has gone up 6% each year since its inception in 2010.
Even policy makers have failed to steady the ship. Ironically, their policies are promoting the price increase of vaccinations. For example, CDC(Centers for Disease Control) is contemplating on a recommendation of Prevnar 13 to people over 65. If this recommendation comes into the force, it will further monopolize the drug maker and increase the revenues by $1 billion.Moreover, there is no policy by CDC to sustain the profitability of solo practices who have smaller purchasing power.
I would like to conclude by pointing out that it’s unfortunate that high cost is a deterrent to the life-saving vaccination in a developed nation like the USA. Below mention policy changes would probably have a positive impact on this grim situation:
1. Vaccination patenting should be discouraged. If this is not possible(in order to give a fair return on investments made on R&D by companies), the length of the patent should be reduced so that monopoly could be countered after certain years.
2. The purchasing power of solo and small practices should be protected and they should be encouraged to participate in the vaccination program.
3. Mandatory vaccination should be provided free by the government (much like what happens in developing nation like India under Universal Immunization Plan).
Trump’s new vaccination safety committee may be a ray of hope? Maybe!
The high cost of life saving treatments (whether it be surgeries, vaccines, or medications) seems to be a common trend lately in our world of healthcare. It's unfortunate that certain companies and the middleman people only see these treatments as profit centers. I wonder what role ethical behavior plays in? I also wonder what the solution to this high price epidemic is?
ReplyDeleteVery well written analysis Navneet, the policy changes that you mentioned at the end I heavily agree with. Having vaccination patenting discouraged would make them relatively more affordable then they currently are. In my opinion the length of the patent should only last about 2-3 years so that a monopoly could not occur.
ReplyDeleteThis was a great analysis. It really worries me that in the United States, not all states mandate vaccinations. I think India is a great example of where the United States needs to take their next step, through government subsidized vaccinations. I'm not too hopeful that this will happen under President Trump as he is a well-known "Anti-Vaxxer."
ReplyDeleteExcellent analysis. You say that the CDC has no policy "to sustain the profitability of solo practices who have smaller purchasing power," but I am not sure if they have the ability to control prices. Certainly, they can recommend policy. We should look into this more. Such great discussions! Yes, @Ben, this is only going to get worse. We need an update on this!
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