Analysis of Cost Versus Care-Should a pediatrician use a less expensive

Analysis of Cost Versus Care

Discussion Question:

Should a pediatrician use a less expensive and
well-established vaccination product with adequate reimbursement rather than a
newer, more expensive version with better bacterial protection that has a lower
profit margin? You should analyze the ethical issues, from the provider,
patient, and healthcare manager perspective.

Case Presentation

In 2001, Wyeth Vaccines (presently known as Pfizer) marketed
a vaccine product known as Prevnar 7 (PCV7). The product enjoyed the full
backing of the Center for Disease Control and Prevention (CDC), and several
professional organizations recommended and endorsed its usage in the pediatric
population. The product was used successfully for over a decade. As predicted,
there was a definitive drop in the frequency of otitis media and, in addition,
there was a diminished number of cases of blood stream infection and meningitis
caused by the 7 (hence the name) subgroups of this particular bacterium.

In 2010, the vaccine producer was granted approval to market
a new version – Prevnar 13 (PCV13) – that added substantial improvement in the
vaccine protection rates, especially now that there would be protection for 13
subgroups instead of the initial 7 groups. As might be expected, the
vaccination also came with a higher cost than PCV 7, and there was substantial
hesitance, initially, on the part of local insurers to cover the vaccination –
as PCV7 was still usable and well-established. Eventually, as it became
apparent that the insurance carriers made PCV13 a “covered service” –
meaning that the vaccine was allowed on the insurance company’s immunization
formulary – the reimbursement margin to physicians providing the new
vaccination would be substantially less that the margin for PCV7.

Members of the local pediatric community engaged in a heated
discussion regarding this issue. Some felt that the parents of the child should
make the decision as to which vaccination they preferred and pay the difference
(out of pocket) for the difference in the vaccine cost. Others advocated a
boycott of the new product, noting that the PCV7 was adequate and that the
protection was sufficient. One of the pediatricians, a local expert in
infectious diseases, stated very clearly that national medical organizations
such as the Advisory Committee for Immune Practices (ACIP) and the American
Academy of Pediatrics (AAP) had issued statements supporting the use of the
newer product. The local medical ethicist – also a pediatrician – argued that
children should not be “held as a hostage” in the deliberation with
insurance companies and that the pediatrician had a prima facie duty to offer
the best available care to the child.

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.