Institute of Medicine Recommends Federal Requirements, Subsidies for Immunizations
The federal government should require all private and public health plans to cover government-recommended immunizations, subsidize related costs for health plans and provide vouchers to the uninsured to obtain vaccinations, according to a report released today by the Institute of Medicine, the New York Times reports. The 11-member panel calls for a "sweeping overhaul of vaccine policy" in response to recent vaccine supply shortages and a "steady decline" in the number of companies producing vaccines, according to the Times. The report, commissioned in 2001 by the CDC, recommends that the federal government provide a fixed subsidy to pay for each vaccine and the cost of administering it. The subsidies would be based on the "societal benefits" of each vaccine, including the ability to enhance the length and quality of life and reduce future medical costs. The IOM said one of its goals was to reduce the role of the federal government -- which buys about 55% of the nation's childhood vaccines and therefore is able to negotiate steep discounts -- in "directly purchasing and distributing vaccine products." Frank Sloan, Duke University health economist and chair of the panel, said that federal vaccine subsidies would have two advantages over direct vaccine purchase: they would increase prices on future vaccines, creating incentives for companies to develop new products, and they would encourage companies "to focus their attention on vaccines that would benefit society the most." The proposals are intended to "stimulate and sustain investment in new vaccines" by assuring vaccine manufacturers "adequate return on their investments," according to the Times. They are also designed to guarantee widespread access to the growing number of effective but expensive vaccines.
The report recommends the federal government mandate that all health insurers cover vaccinations for all insured children, for adults age 65 and older and for individuals age 18 to 64 with a high risk of developing diseases preventable by vaccination. The government would provide vouchers to uninsured people to obtain vaccinations at any doctor's office or clinic (Pear, New York Times, 8/5). Further, the report says the federal government should consider the cost, benefit, safety and effectiveness of immunizations before recommending new vaccines; currently, cost is not taken into consideration, USA Today reports (Manning, USA Today, 8/5). The recommendations would increase federal spending on vaccines by an unspecified amount, and they are subject to congressional approval (New York Times, 8/5).
Dr. Walter Orenstein, director of the National Immunization Program at the CDC, said the recommendations are "a step in the right direction" but added that it is "too early" to endorse the proposals, the Hartford Courant reports (MacDonald, Hartford Courant, 8/5). Dr. Donald Young, president of the Health Insurance Association of America, said he would be "wary" of a new federal coverage requirement, according to the Times (New York Times, 8/5). "We believe the best health benefit design emerges from conversations among employers, employees and health plans," he said. Karen Ignagni, president of the American Association of Health Plans, also expressed concerns over such a requirement but said the organization agrees with the goal of improving access to immunizations (Hartford Courant, 8/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.