Wednesday, July 20, 2011

Costs and Effectiveness and Vaccine Policy

I have written before about issues related to the costs of vaccines (for example, here and here).  They are expensive to develop, and have inherent risks.  At the same time, they’re not the greatest profit generators, in part because they’re used once or twice, unlike, say, cholesterol drugs that patients take regularly for years and years.

Today there was an interesting story on NPR’s All Things Considered.  Titled, “Rising Costs Complicate Vaccine Guidelines,” it looks at a meeting of the Advisory Committee on Immunization Practices (ACIP).  According to the ACIP web site,

The role of the ACIP is to provide advice that will lead to a reduction in the incidence of vaccine preventable diseases in the United States, and an increase in the safe use of vaccines and related biological products.

The Committee develops written recommendations for the routine administration of vaccines to children and adults in the civilian population; recommendations include age for vaccine administration, number of doses and dosing interval, and precautions and contraindications. The ACIP is the only entity in the federal government that makes such recommendations.

The NPR story focuses on a difficult place in our health care: the point where we discuss balancing cost and effectiveness.  While the specific vaccine in the example is for meningitis, it offers a good examination of all those difficult questions: at what cost do we treat, and with what effect? Who makes that decision, and on what basis? Each decision has both costs and benefits, and each choice excludes other choices.

Take a few minutes and listen.  It won’t give definitive answers (although it does tell us what ACIP decided in this case), but it will bring us back to important questions.

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