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Health Care—Health care providers are faced with soaring prices for flu vaccine

San Clemente pharmacist David Mitchell rang in the second day of 2001 with a delivery of what has become one of last year’s most sought-after commodities: flu vaccine.

Due to a shortage of vaccine for this flu season, health care providers have been faced with soaring prices for limited quantities of vaccine. Patients ability to get innoculated has often been determined by whether they know a provider who was willing and able to pay the higher cost.

Mitchell said a former nurse came to see him at the Del Mar Value Rite Pharmacy in San Clemente because her doctor, like many others, had not been able to obtain an adequate supply of flu vaccine, Mitchell said.

“A lot of doctors vaccinated their high-risk patients first, but then ran out,” he said. Other doctors were lucky to get their hands on flu vaccine at all.

Manufacturers say vaccines were delayed last year because of difficulty in growing one strain and quality control problems.

Traditionally, health care providers receive their flu vaccine in September. But many hospitals, clinics, doctors and others didn’t get the bulk of their flu vaccines until three weeks ago.

Strapped to serve their high-risk patients, many health care providers agreed to buy the vaccine at inflated prices while they awaited delayed deliveries. Mitchell was among them.

After waiting until mid-December to receive a mere six vials out of 80 vials ordered in April 2000 from a purchasing group called Independent Pharmacy Cooperative, Mitchell turned to an alternate source.

On Dec. 18, STAT Pharmaceuticals Inc., a local distributor of hard-to-find pharmaceutical and medical supplies, sold Mitchell eight boxes of prefilled syringes for $89.95 per box.

There are 10 syringes in one box.

He turned down vials offered by STAT, because they cost the same and Mitchell wanted to save the pharmacy the additional cost of syringes, though he prefers to buy syringes separately.

Under his contract with Independent Pharmacy Cooperative, Mitchell paid $25 per vial. STAT Pharmaceuticals asked nearly four times that price for the same amount of vaccine last month, he said.

Trouble Getting Product

But Gene Alley, president and CEO of STAT Pharmaceuticals, which is based in El Cajon, said distributors aren’t to blame for the higher prices.

He said STAT also paid more to buy vaccines from secondary distributors while awaiting a delayed delivery.

The original order was for 300,000 doses of vaccines from Henry Schein Inc. in New York, the exclusive supplier of Oxford, England-based vaccine-maker Medeva.

Alley declined to say who the alternate distributors were and how much he paid for the vaccine. He said at one time during 2000 STAT Pharmaceuticals made a $25 profit per vial sold. There are 10 doses in one vial.

Susan Farrell, executive director of the Federation of Pharmacy Networks in Laguna Niguel, said 2000 was the worst vaccine shortage in the six years she has worked with the nonprofit organization.

“Everybody was late in receiving it,” Farrell said.

The federation has 20 member buying groups representing independent pharmacy owners. Among them is Mitchell’s pharmacy.

Farrell didn’t want to speculate on a possible repeat of last year’s vaccine shortage this year. She blamed the severe shortage on manufacturing problems.

Specialization

Only a few firms specialize in flu vaccines. The major producers are Aventis Pasteur in Lyon, France, and Wyeth-Ayerst Laboratory, the Madison, N.Y.-based pharmaceutical unit of American Home Products.

Another producer, Monarch Pharmaceuticals, a unit of Parkedale Pharmaceuticals in Bristol, Tenn., shut down its flu vaccine production, she said.

Alley said most people knew of these problems well in advance. But, he added, if one manufacturer shuts down, the market will be hit hard.

“You’re all of a sudden short of 10 (million) to 15 million doses,” Alley said.

At Kaiser Permanente in San Diego, the flu clinic remained closed until December because of delayed delivery of 160,000 doses of the vaccine from Wyeth-Ayerst Laboratory, a spokeswoman said.

“We got some of it in October, most of it in November and December , but it trickled in and we never knew what was coming,” said Sylvia Wallace, a local Kaiser spokeswoman.

The price for the vaccine remained the same.

By contrast, the UCSD Medical Center in Hillcrest paid more to receive an additional order from manufacturer Aventis while waiting for delayed delivery from the same company, said Lawrence Stephanson, a pharmacist at the medical center.

“We ordered an additional 5,000 vials in November from Aventis, which were delivered in December at $50 a vial,” Stephanson said.

He didn’t comment on the price in the contract. For now, Stephanson is glad to see UCSD employees finally getting their vaccinations too.

Overstocked

Ironically, many of the same health care providers who discouraged healthy people from getting a flu shot are now changing their tune.

And distributors like Alley, who three weeks ago sold vaccine at double the normal price, are now eager to get rid of the perishable goods.

Alley said he has 650 boxes of prefilled syringes in stock, which as of Jan. 2 cost $39.95 a box. He admits the times when people were banging down his door to buy vaccine likely is over , at least for this flu season.

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