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The federal government should subsidize the cost of all vaccines recommended for children and adults, a new report says. It calls for a major overhaul in the way vaccines are paid for in the USA.
The plan proposed by the Institute of Medicine, a branch of the National Academy of Sciences that advises the federal government on health policy, would shift the bill for all recommended vaccines from patients to the federal government. Insurance coverage for vaccines varies widely.
The plan also would require health care officials to consider the benefits and costs of a new vaccine before adding it to the list of federally financed immunizations.
The price tag for implementing the recommendations, which come at a time when deepening budget deficits are capturing public attention, would depend on such factors as the cost of vaccines and how many people would get them, says the institute's committee chairman, Frank Sloan of Duke University.
The government currently buys 56% of childhood vaccines under the Vaccines for Children program, which provides immunizations for children who are poor or under-insured. But the growing number of recommended vaccines and soaring prices have doubled the program's costs in only two years, from $500 million in 2000 to nearly $1 billion in 2002, according to the report, ''Financing Vaccines in the 21st Century: Assuring Access and Availability.''
There's no end in sight: New vaccines in the pipeline could cost $50 to $500 a dose, the institute says. Its proposals include:
* Federal legislation to require public and private health plans to cover immunizations for children, people 65 and older and adults 18 to 64 who have chronic illnesses. Vouchers would be offered to uninsured people.
* A federal subsidy that would reimburse insurers for vaccines and associated costs.
* A requirement that health care officials consider costs and benefits to society, along with safety and effectiveness, before recommending new vaccines. Currently, cost is not considered.
''The primary vision is that any child or adult walking into a doctor's office will be vaccinated, and there will be no concerns about who's going to pay for it,'' says institute committee member Eric France, who is chief of preventive medicine for Kaiser Permanente in Denver.
The industry's first reaction was positive. The report represents the institute's first acknowledgement of a link between financing and the stability of the vaccine supply, says Chris Grant of Aventis Pasteur. ''That is significant to us,'' she says. ''And welcome.''
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