AAFP should act to avoid flu vaccine problem, says Congress -- Post-Assembly Edition/November 2001 -- FP Report

November 2001 • POST-ASSEMBLY EDITION

AAFP should act to avoid flu vaccine problem, says Congress

BY JANE STOEVER & TONI LAPP

L ate supplies, rising costs, uneven distribution problems: That's just the short list of flu vaccine issues the Congress of Delegates addressed Oct. 1 3 in Atlanta.

Dennis Saver, M.D., discusses his concerns about this year's flu vaccine supply with Barbara Paul, M.D., of the Centers for Medicare and Medicaid Services.

"I'm a solo rural family physician, and after last year's debacle (with vaccines coming late to many physicians' offices), I got stuck with a lot of extra immunizations that I had to eat the cost of," said alternate delegate Maggie Blackburn, M.D., of Harpersfield, N.Y. Many of her patients were immunized at local stores before she could offer them the vaccine.

"This year, the companies are charging much, much more, and I have told my patients to go to Eckerd's, go to Kmart, go to Price Chopper, because I can't afford to be in this business," said Blackburn.

Vaccine wholesale prices went up by as much as 67 percent from last year to this year. In early September, the Centers for Medicare and Medicaid Services said it would reimburse $4.26 for each dose of the vaccine. By now, CMS has hiked the payment.

"The Medicare carriers in all but three states will be paying $7.12 or $7.13 per dose," Barbara Paul, M.D., medical adviser to CMS, said in reference committee testimony. "The agency has been working very closely with the CDC and the AMA and other physician associations on this issue, and we're very concerned about it. But we have updated the prices, and you should see that reflected in your payments."

Dennis Saver, M.D., of Vero Beach, Fla., the AAFP 2001 Family Physician of the Year, told delegates, "The circumstances of this price increase look very suspicious. There are now only two U.S. manufacturers. They have a vise grip on the supply, there is not a projected shortage, and the price is up. I think it needs to be investigated through legal mechanisms that have to do with anti-competitive practices and monopolistic practices."

Delegates urged the AAFP to:

deliver the message to manufacturers and the public that mass immunization programs should be held only after physicians and health care facilities have been able to immunize patients at high risk;

educate members about distribution and pricing variations so they can avoid taking a financial loss while providing a key clinical preventive service;

work with AAFP chapters, AMA, state medical societies, CDC and local public health officials to develop coordinated community plans for distribution in the coming years;

protest and challenge the unjustifiable price increases and the public health crisis they create; and

investigate the causes of shortages of tetanus, flu and other vaccines and recommend ways to prevent future vaccine shortages.

Because of concerns over the delay of the flu vaccine this year, the Academy has approved a prioritization policy to ensure that high-risk patients are immunized first. The prioritization policy can be viewed at http://www.aafp.org/policy/camp/27.html.

FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.

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	Dennis Saver, M.D., discusses his concerns about this year's flu vaccine supply with Barbara Paul, M.D., of the Centers for Medicare and Medicaid Services.