AMA Decries Flu Vaccine Price Gouging

By JULIE MARQUIS

Nov. 4, 2000 12 AM PT

TIMES HEALTH WRITER

Unprecedented delays and uneven distribution of the flu vaccine--complicated by alleged price gouging--are causing alarm among health officials who warn of severe disease and even deaths among their most vulnerable patients.

Production problems among manufacturers have led to temporary shortages of the vaccine this season. Indiscriminate use and heightened demand even among healthy people concerned about the shortages have exacerbated supply problems.

On Friday, the American Medical Assn. formally condemned certain distributors for raising their prices as much as 500%.

“Medical price gouging is unethical and threatens the health of those who need the vaccination most,” said Dr. Richard F. Corlin, president elect of the association and a Santa Monica-based gastroenterologist. “It is not an exaggeration to say that these ruthless business practices could result in serious illness or death.”

At the same time, the California Medical Assn. released a statement saying it was “outraged at the profiteering and greed that has accompanied the distribution of this year’s vaccine supply.”

Many health experts said the flu season is not expected to peak for two months or more and that plenty of vaccine will reach the marketplace--probably by late November or early December.

For now, however, only a third of the necessary supply has been distributed nationwide. The AMA and the U.S. Centers for Disease Control and Prevention have recommended setting priorities on who gets flu shots. Vaccination is considered particularly important for people over 65, nursing home residents, those suffering from chronic or debilitating diseases and women in their second or third trimesters of pregnancy.

But doctors and other officials say that message is not being heeded.

“It is an outrage that a big-box discount store and chain grocery stores with pharmacies attached have ignored widespread public health recommendations and are doling out scarce flu shots to anyone who will stand in line to shell out $9 or $10,” Arthur D. Silk, an internist from Garden Grove, wrote in a letter to The Times. “Meanwhile none of my colleagues have been able to get any vaccine even for their most vulnerable patients.”

While a fair number of hospitals and clinics have received at least some of their pre-ordered vaccine supply, Silk’s complaints were echoed by many of his peers throughout the region.

“We ordered 30,000 dosages for our patients, and we haven’t gotten any,” said Dr. Ronald Bangasser, whose 132-doctor medical group in San Bernardino County serves about 14,000 senior citizens. “This is something I am just so disgusted about. It’s not going in the right direction--to people at risk for pneumonia and not pulling through. The CDC put out the [priority] guidelines but it’s not happening that way.”

Elderly and chronically ill patients are upset as well.

“There is no excuse for this--no excuse,” said Joseph Lotts, a 73-year-old Los Alamitos resident with congestive heart disease who has been told he has to wait for his shot. “I don’t want to toy around with any sort of sickness. . . . It could be fatal.”

Michael Torgan, vice president for quality improvement for Country Villa, which has 22 nursing homes in the Southern California area, said supply problems are worse this year for facilities that ordered their vaccines through pharmacies, rather than California’s Department of Health Services.

“[Our] pharmacy has only received 10% to 20% of their total request,” he said. “They’re at the mercy of their supplier.”

A few drugstore chains have received so little of their orders that they have canceled plans for customer vaccination clinics. In an unusual gesture, Rite Aid Corp. has postponed 400 clinics and is offering its limited supplies to physicians, hospitals and medical suppliers most in need, a spokeswoman said.

But many other chains are proceeding with large-scale clinics.

“We don’t see any practical way of screening people at our stores,” said Michael Polzin, a spokesman for Walgreen Co. He said the chain emphasizes in promotional material that elderly and other susceptible people should get their shots early.

The perception of price-gouging on the part of distributors has only added fuel to the ire of physicians and others facing short supplies.

“Last year we were paying $4 a dose, pre-booked,” said Dr. Tom Horowitz, a family doctor in downtown Los Angeles. To buy the vaccine from a distributor this year, he said it runs $8 a dose--a 100% markup that Horowitz considers outrageous.

The Centers for Disease Control, which does not regulate distribution of vaccine, says the markups seem to be concentrated among smaller distributors. At least one manufacturer, Wyeth-Ayerst in Radnor, Pa., says it is unaware of such price inflation with its product.

One distributor said Friday that it is unfair to blame companies like his for pricing problems. Martin Bradley, president of Bio-Med Plus in Miami, said his company is at the end of a long chain of wholesalers and middlemen. By the time the vaccine gets to him, the price often is already elevated, he said.

Bradley, whose company distributes a small amount of flu vaccine, acknowledged that he has charged $150 or more per vial--or about $15 per dose. But he said his price depends on his costs. His overall margin is about 28%--not unreasonable by his estimation.

“I’m not gouging,” he said. “I wouldn’t do that.”

Dr. Marcy Zwelling, an internist and critical care specialist in Los Alamitos, said that in times of shortage, vaccine distribution needs to be regulated.

“This is a public health issue,” she said. “We have a drug here that is potentially life-saving. We are not distributing shoes for the prom.”

Times staff writers Noaki Schwartz and Jane Allen contributed to this story.

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Contact Information

on Flu Shots

For more information on the flu vaccine, check with the following health departments:

Los Angeles County

(800) 427-8700

Web site: https://lapublichealth.org/

ip/flu/cl_city.htm#LOS ANGELES

Orange County

(714) 834-7982