Managed Care - August 2008 - (Page 32) Plans Feel Pressure To Vaccinate More Adults The cost-effectiveness of prevention is undeniable, yet vaccination rates for everything but influenza decline By Martin Sipkoff Contributing Editor year if the portion of adults 50 and older who get flu immunization were increased to 90 percent. It is now at only about 37 percent. For other largely preventable diseases, the CDC estimates that only 2.1 percent of adults ages 18– 64 are immunized against tetanus, diphtheria, and whooping cough, although since 2006 there has been a combination vaccine for all three. Among other immunizations, only about 10 percent of women ages 18–26 have received the new vaccine for human papillomavirus, linked to cervical cancer. A dults are notoriously lax in being vaccinated, even for influenza. “There’s a large body of evidence that supports the importance of adult vaccination,” says Michael Belman, MD, a WellPoint medical director. “We believe it is part of our responsibility to encourage them through messaging and education.” “Vaccines work, they are a true success story,” agrees Ed Pezalla, national medical director for Aetna Pharmacy Management. “We review and Recurring problem promote all vaccines with the best possible Medicare or Medicaid pays for many vacclinical outcome in mind.” cines for most adults over 65, but for adults No doubt, but that may not be getting under 65, insurance often doesn’t cover all through to the public. Immunization rates for types of recommended vaccines. Some pubchildren are at an all-time high, but their parlic health officials are calling on plans to do ents apparently don’t extend that same conmore to encourage adult vaccination. cern to themselves. According to the Centers Legislation has been introduced in Confor Disease Control & Prevention, as many as gress that would create a national vaccine 70,000 adult Americans die each year from program to provide free immunizations for diseases that vaccines can prevent, such as “Vaccines work. uninsured and underinsured adults. The Nainfluenza, pneumonia, and complications of They are a true tional Business Group on Health recently recsuccess story,” hepatitis. ommended that its members make 100 persays Ed Pezalla of The treatment of these diseases costs more Aetna Pharmacy cent coverage of all CDC-recommended than $10 billion a year. That is shocking when Management. vaccines part of contract agreements with you consider that the CDC estimates that the “We review and health plans and educate their employees promote all average private-sector cost to vaccinate a about the benefits of vaccination. vaccines.” healthy adult through age 74 with univer“Low immunization rates are a national sally recommended vaccines is approximately $380 public health crisis,” said William Schaffner, MD, to $480, depending on the brand. president-elect of the not-for-profit National FounInfluenza vaccine is the one most commonly acdation for Infectious Diseases in a recent public cepted by adults, but even there the public health statement, calling on health plans and employers to record is depressing. According to a coalition of do more to encourage vaccination. “Infectious disbusinesses, nonprofit organizations, and governeases kill more Americans annually than either ment agencies named the Partnership for Prevenbreast cancer, HIV/AIDS, or traffic accidents.” tion, more than 12,000 lives could be saved each Pressure on payers is growing because the adult 32 MANAGED CARE / AUGUST 2008
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