In praise of profiteering on vaccine prices


The scandale du jour seems to be that people are raising the price of something that is in short supply. Quite what anyone is supposed to do other than that is not detailed but it's definitely a scandal:

Private clinics have been accused of “cashing in” on the increased demand for meningitis vaccinations by charging up to £750 for a child’s treatment. This is more than 12 times the cost of the same three-dose course on the NHS, which is around £60.

Parliament are expected to discuss reversing a controversial decision to limit the meningitis B vaccine to babies under nine months after MPs acknowledged that a record-breaking online petition had to be "taken seriously".

The petition, which has been signed by more than 800,000 people maing it the most signed in parliamentary history, calls for all children under the age of 11 to be given the vaccine.

Vaccination is of course a good thing in general: it's one of the great advances in public health of the past few centuries, ensuring that ever fewer of us die of the common childhood diseases. It also leads to that public good of herd immunity which is a very good reason indeed for there to be state intervention and possibly state subsidy. That is, after all, one of the major reasons for having government, to gain those public goods which we cannot gain in any other manner.

Sadly, meningitis vaccines tend not to produce herd immunity but that's a slightly different matter. Dependent upon the sub-type it is possible to be personally protected and yet still carry and possibly infect.

Yet this is simply wrong:

Sue Davie, head of the charity Meningitis Now, told The Daily Mail: "It would clearly be wrong for anyone to profiteer from this situation. This vaccine should not only be available to those who can afford it."

Ian Liddell-Grainger, a member of the All Party Parliamentary Group for Child Health and Vaccine Preventable Diseases, said: "For clinics to profiteer on something which is affecting people's health and lives is disgraceful.

"People's lives are being played with. To charge £250 a dose really is disgusting. I will bring this up in Parliament if I can."

Because that isn't the situation at all. Those wise people at NICE and elsewhere in the health service have done their best to look at the costs and benefits of this particular vaccine. It's part of the regular childhood set now. And that part is entirely unaffected:

Due to unexpected global demand for Bexsero during 2015, we are experiencing supply constraints during the first half of this year.

Although vaccination through the NHS childhood programme has been prioritised and is unaffected, we have unfortunately had to ask private clinics temporarily to not start new courses of vaccination.

Children who have already started their course of the vaccine privately should still be able receive their follow up doses.

So, where it is considered medically appropriate this vaccine is available in the usual manner, through the NHS. For others who desire this vaccine there is a shortage of supply. There is, quite literally, nothing at all that can be done to increase this supply in the short term. In the medium term there will be increased supply.

What then should anyone be doing to allocate that very limited (in fact, the drug company itself is indicating no further supply at all to the private market)? Who, where and how, should be making the decision as to who gets that limited supply and who does not?

Note again, all the actions to increase supply are already happening. Even a Manhattan Project style program isn't going to increase that supply before the summer.

Clearly, what should be happening is what is already happening. Supply to those with medical priority, the 9 month old babies, is already both prioritised and ensured. The remaining supply is being allocated to those who value it most: as it should be, on the basis of price. There is no other sensible manner of doing this.

Just what is the solution that anyone else would offer?