The current system of supplying vaccines and immunizations is facing new challenges including continued disparities in immunization across geographic and demographic populations, periodic shortages of vaccines, few incentives to develop new vaccines, declining number of vaccinations and erosion and fragmentation of insurance coverage for immunizations.
To deal with this crisis, a recent report by the Institute of Medicine (IOM) calls for major changes in the current system of financing vaccines. The IOM report proposes a three-part plan made up of a federal government mandate, subsidy for vaccines based on their estimated value, and granting vouchers to insured individuals. The federal mandate would require that vaccine benefit be included in all private and public insurance plans including Medicare, Medicaid, and State Children Health Insurance Program. The federal government should also provide subsidy per vaccine to reimburse health plans and providers for the purchase costs and administrations fees created by the mandate. The subsidy would be based on societal value of vaccines administered. Finally, the federal government should give vouchers to uninsured individuals so that everyone has an access to immunizations and those providers who administer vaccines are reimbursed for their expenses.
The major purpose of the mandate is to guarantee that everyone has access to the growing number of new and expensive but effective vaccines and at the same time it wanted to stimulate and sustain investment in vaccines, by assuring that manufacturers could achieve an adequate return on their investments.
The report also recommends changes in composition and decision-making procedures of the Advisory Committee on Immunizations Practices (ACIP), the government body that currently recommends vaccines. These changes would bring transparency in the working of ACIP and consequently reduce the costs of new and effective vaccines.
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