In Maine patients phoning their doctors' offices to ask about flu shots are finding out there are none but are told they might check with local supermarkets and car dealerships. The story has been going around that these establishments have gotten hold of some flu vaccine and were using it to draw in street traffic.
Once again the supply and distribution of flu vaccine is screwed up. Although 52 million doses have been shipped, according to the Centers for Disease Control, they have not arrived in a number of places. Some clinics have reported their vaccine orders have even been canceled.
The mess is systemic, not episodic, and so much so that the less than socialistic Wall Street Journal was recently moved to say, "Marketplace forces aren't providing some of the drugs the public needs most.... The same market forces that reward the production of Lipitor, Viagra and other drugs for chronic conditions have proved a poor way to provide some of the antibiotics and vaccines that the public needs most."
Developing and making vaccines is a red-ink activity for the most part. The would-be makers will tell you that one reason they don't like the vaccine business is the likelihood that they will get their britches sued off them, not because their product is defective or doesn't work. They get sued because vaccines are said, without much proof thus far, to cause everything from asthma to autism.
Vaccines are low-profit products. They need to be made in vast quantities that are not always used--and then who is to pay for the losses involved in their storage or their destruction?
Over the years and at considerable expense, drug companies have learned that people will not pay big money to prevent a disease, only to treat it. It's been said that drug companies make twice as much selling AIDS medicine as they could make from an AIDS vaccine. After all, a totally effective vaccine eliminates the need for itself. From a drug company's point of view, polio and smallpox are examples of the fact that an ounce of prevention is not worth a pound of cure. To the contrary: Companies, no matter what the industry, do not want to be in the business of putting themselves out of business.
A similar situation exists with antibiotics. When a new antibiotic hits the market these days, doctors hold it back and use it sparingly to prevent bacteria from developing a resistance to it, as has happened with the promiscuous use of earlier antibiotics. That's good for health but bad for business. As a result, few antibiotics are being developed in an era when new kinds of staphylococcus are killing people inside hospitals and out.
Occasionally even now a company may hit it big with an antibiotic, as did little-known ViroPharma. With the introduction of the colitis-fighting drug Vancocin, the stock has jumped from pennies in the spring to more than $20 a share in the autumn. ViroPharma gets $800 for a course of treatment, but anyone would be happy to pay that and more for the only antibiotic certain to cure an infection that otherwise will eat your guts out. It will eat your stomach out if you can't find the money to pay, which is why some doctors have denounced the price as outrageous.
But business is business. Whether you are selling machine guns or miracle drugs, the principles are the same, which may have something to do with the Journal reporting that "Economists generally agree that in markets like these government should step in--just as governments deliver services such as police, roads and national defense because they benefit the public collectively."
Markets are indispensable for many things, but not the public's health. Like penicillin, they must be intelligently applied.