Tuesday, September 8, 2009

To Vaccinate or Not to Vaccinate, Cost is the Question

We've been talking a lot about vaccinations the last few days, especially developing new vaccines for H1N1 and potentially HIV. The article I found, however, talks about how some physicians are administering fewer vaccines now than in the recent past. As is so often the case, this phenomenon is largely the result of high costs that private practice doctors experience when administering vaccines. Simply put, vaccines are not profitable for these physicians. The costs for a physician to obtain, store and administer a vaccine are not completely covered by the doctor's insurance. While many insurers cover the complete cost of buying the vaccine, physicians typically end up paying 17 to 28% above the cost of the vaccine itself in storage and administration costs.

This trend is troubling because it means that many children may go without standard vaccines like measles, mumps and rubella or chickenpox. Experts point to the period between 1989 and 1991, when vaccination was also cutback due to costs, as a potential and scary example of what could occur now. In that period, MMR vaccine administration fell, resulting in "55, 000 cases of measles, 11,000 hospitalizations and 123 toddler deaths."

While it remains uncertain how widespread the cutbacks will be, (a recent survey estimated that "5% of pediatricians and 11% of physicians indicated that they're seriously considering no longer offering immunizations"), the potential effect on public health is worrisome. Preventive medicine is clearly preferable to therapeutic treatment, but this trend away from vaccination may put an even larger burden on hospital based, reactionary care. This trend also highlights the importance of economics in healthcare, whether it is drug makers or private practice physicians, everything seems to end up being about costs.

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