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Costly vaccines threaten healthy immunization system

By TOM MARSHALL
Published March 24, 2007

The nation's pediatricians, foot soldiers in the campaign to vaccinate America's children, are starting to revolt against the high cost of vaccines.

Doctors say rising price tags and the sheer number of new vaccines make it increasingly difficult to buy the shots they give their patients. They also complain that insurers often do not reimburse them enough.

"We're really getting caught in a bind," said Dr. F. Lane France, medical director of the Pediatric Health Care Alliance in Tampa.

"We tie up sometimes $200,000 or $300,000 in the refrigerators," he said. "We can't afford to pay all that money out and not get it back for maybe months."

Some insurers pay doctors less than the cost of drugs like Prevnar, which fights invasive pneumococcal disease, France said.

"One company, we get something like $50 for Prevnar, which costs $80," he added.

Not all doctors are feeling equal pressure. Dr. Mark Morris of Florida Pediatrics in St. Petersburg said vaccine costs have caused cash-flow problems for medical practices, but said reimbursement from insurers like UnitedHealthcare was "adequate."

Nationally, some pediatricians are not offering the newest and most costly vaccines. Some public health experts warn that if the situation worsens, the nation's immunization program could break down, causing a rise in preventable diseases.

Some doctors are asking patients to pay up front or, in a new twist, sending them to the drugstore. France said his doctors encourage families to visit local health departments for some vaccinations when they can.

"We're not refusing anyone yet, it hasn't come to that," he said.

In 1980, it cost only about $23, or $59 adjusted for inflation, for the seven shots and four oral doses needed to immunize a child, according to data provided by Thomas Saari, emeritus professor of pediatrics at the University of Wisconsin.

Today, a child who gets all the recommended vaccines would receive as many as 37 shots and three oral doses by the 18th birthday - at a cost exceeding $1,600.

Information from the New York Times was used in this report. 

[Last modified March 24, 2007, 21:16:19]