Skeptical Raptor's Blog hunting pseudoscience in the internet jungle

Why we vaccinate–the cost of catching the flu

Syringe with moneyThe tropes of the antivaccination horde would be laughable if it weren’t for the seriousness of the diseases that are prevented by vaccines. Even among those people who vaccinate their children for everything, they’ll make up all kinds of lame excuses for not getting the flu vaccine, all easily debunked. And someone will call you a “dumbass” if you use any of those worthless excuses. 

One of the most annoying tropes of the vaccine deniers is that somehow Big Pharma (even though some vaccines are sold by Baby Pharma) is forcing dangerous, expensive, and highly profitable vaccines on the market because Big Pharma is nothing more than greedy, unethical executives sitting in their huge offices figuring out which Ferrari they’re going to purchase next week. Setting aside the fact that most Big Pharma execs are far too conservative to drive a Ferrari, does this even make any sense whatsoever? 

Let’s get this out first. Big Pharma corporations are generally public, and as such, their shareholders expect them to make profits. But corporations don’t generate profits by turning on a cash printing machine, they must invent, develop and manufacture products, distribute it to the market, and do it well enough to actually generate profits to not only pay their shareholders, but also to invest in the next round of invention, development and manufacturing for the next set of products. Big Pharma has an extremely complex relationship with its market because bringing new products to their customers requires a huge investment in resources (from research to engineering to manufacturing). And Big Pharma has a wide variety of customers including the patient, the physician, the hospital, the insurance company (or government versions of insurance, like Medicare), the government and its regulatory arms, and many others.

In the world of Big Pharma, there is a strong culture of providing better and longer lives for patients, better tools for physicians, lowest possible costs for the health care system, and being honest and forthright with government agencies. They believe if they do all of that right, the profits will flow naturally. Do they err? Certainly, Big Pharma is made up of imperfect humans who make bad judgement calls, or think their decisions are above the law. But to condemn the hundreds of thousands of people in Big Pharma as evil is just plainly delusional.

Let’s look at vaccines. To get one vial of vaccines from a manufacturing plant in Lyons, France to a pediatrician in Elkhart, Indiana would take 20 pages to describe. To discuss how that vial is priced at each level, and then provided under contracts to insurance companies, distributors, and finally the patient, would require another 20 pages. Antivaccination gangsters oversimplify everything about vaccines and Big Pharma. It takes real science to understand everything about vaccines, immunology, and infectious disease. Similarly, it might take years of business knowledge (including an MBA in Finance and Accounting) to fully comprehend the business model of vaccines. If it were as simple as the vaccine deniers claimed, then “everyone could do it.” 

In this blog, I spend quite a bit of time trying to explain the science of vaccines, with most reasonably intelligent people getting it, and the deniers still hating real science. There comes a point where you can only do so much to show them real science–if these vaccine refusers want to deny science, then that kind of ignorance is almost impossible to overcome.

But the trope of Big Pharma pushing vaccines so that they can fill the vaults with pure gold–that’s just a delusion of a whole new level of ignorance. If Big Pharma was so unethical and so devoted ONLY to making money, then their only choice would be to stop selling vaccines. Because they make so much more money with sick people laying in hospital beds than living normal, healthy lives completely immune to vaccine preventable diseases. (Actually, the trope of “Big Pharma only wants to keep people sick” is a pretty important one amongst the woo-pushers.) So we have competing tropes. One says they’re pushing evil vaccines to make money. But another trope says that they want people sick (precisely what vaccines prevent).

During the past few weeks, you’ve probably read about the 2013-2014 H1N1 flu outbreak, which is attacking unvaccinated adults. Unlike other years, however, this season’s flu is occurring in younger, healthier individuals as opposed to older individuals with underlying chronic diseases. So what is the cost to prevent the flu? Or treat it? These are actually almost two separate costs (although a few individuals who are vaccinated catch the flu).

The cost of an individual dose of flu vaccine (in the United States) ranges from $8.00 to $21.00 depending on lots of factors including whether the CDC acquires the vaccines for the Vaccines for Children Program (VFC), a US Government sponsored program to provide vaccines for free to those without insurance or too poor to afford the vaccines, or whether someone is purchasing the vaccine at cost from a distributor or other source. This cost is substantially lower than what you might pay when you go to a drug store or some other place, because they are adding in the costs of the syringe and nurse, along with the overhead of the drug store. Almost everyone in the USA who has some type of health insurance gets the flu shot for free or at some small cost ($5-10) through their insurance carrier. Generally, the average price paid to vaccine manufacturers across all markets (hospitals, insurance, VFC) is about $15.00–this is not the price an individual patient will pay, because there are so many factors, but it is the price that whoever is giving the vaccination is paying. (See, I told you this was complex.)

Using 2009 H1N1 numbers (the most recent year with extremely detailed statistics), approximately 81-91 million people were vaccinated. Let’s assume that in 2013-14 about the same number will be vaccinated, but with population growth and news/social media pushing vaccines, I’m going to estimate that around 93 million will be vaccinated.

Simple math, $15/dose X 93 million is equivalent to approximately $1.395 billion in revenue (in the US only). 

But that’s just revenue. According to several estimates, the Net Profit from vaccines is about 10.4% (substantially lower than the net profit of around 12-15% for other drugs). So the Net Profit from vaccine sales in the USA is around $145 million. Admittedly, that’s a lot of Ferraris to buy, but let’s look at the alternate view.

In 2009, approximately two-thirds of the population were not vaccinated. About 270,000 people were hospitalized, the bulk of which were not vaccinated. If we vaccinated no one against the flu, the number of hospitalizations would have been closer to 405,000. This number would probably be higher because without vaccinations the disease would have spread faster to more of the population.

A recent study outlines the direct medical costs for low and high-risk patients who are hospitalized as a result of the flu. The average is around $15,000 per patient, but the number skyrockets to an average of $50,000 for high risk patients.

But using the smaller number of $15,000 X 405,000 hospitalizations, we would have a net cost of  $6.1 billion to Americans who are hospitalized for the flu in a year like the 2009 H1N1 outbreak. 

Of course, not all of that $6.1 billion goes to Big Pharma. In general, about 35% of a hospital bill can be attributed to the costs of consumable products (bandages, syringes, IV’s, medications, and other products sold by Big Pharma). In other words, around $2.1 billion. On these products, Big Pharma gets closer to a 13% net profit, or $276 million. That’s nearly double what they make off of the vaccines in the same period of time.

In conclusion, the greedy, immoral capitalists running Big Pharma are complete fools, who flunked out of business school. They should drop vaccines and let everyone get sick, because their net profit will double. Overnight.

Sadly for the shareholders of Big Pharma, it’s actually made up of ethical, moral, and well-meaning individuals who do their best to help save lives while still being good capitalists and make money for the corporation and its shareholders. 

Despite the tropes, lies, and ignorance of the antivaccine movement, the vaccine story is infinitely more complicated than you could ever imagine. Making up stories about the ingredients of vaccines harming your children is no different than making up stories that Big Pharma creates vaccines JUST to make money. Vaccines keeps people out of hospitals, and fewer people in hospitals bring less money to Big Pharma. If you really think about this issue, you’d come to the realization that antivaccine hoodlums are just shilling for Big Pharma.  

Use the Science-based Vaccine Search Engine.

 

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