Jean Antonucci MD in Farmington ME is in a jam that is reflective of many solo independent practices in the States. Because of rampant poverty in ME, many of the children who come to her are covered by a state vaccine program. The few remaining don't make up much volume in her practice.
Jean sees her role as a primary care clinician providing vaccine administration because it is the right thing to do.
The problem is that Wyeth won't sell Prevnar in less than a ten pack. With the low volume need in non-state covered kids, the ten pack goes bad and Jean has to eat the cost.
Jean is getting past the learned helplessness of many PCPs and called Wyeth directly, eventually speaking to David Ross, A.V.P. of Wyeth Vaccines.
Here's a paraphrased quote: "Dr. Antonucci - this is the first I've ever heard of this problem. You're obviously a unique doc and we can't change our way of business just for one doc. If I heard from lots of docs that this was an issue, then maybe we could do something."
I found Mr. Ross' contact info on Plaxo and left him a polite voicemail. It took all of two minutes. Maybe others would consider doing the same. [I also set up a web page for this on SavingPrimaryCare.org]
We should not ask Jean and many other independent practices to choose between giving up on vaccines (turf to the health department) and eating the (substantial) cost of wasted vaccines.
Wyeth could package and ship individual vials. Wyeth could partner with a distributor like Cardinal Health. Wyeth could partner with retail pharmacies. There are options in addition to "suck it up."
L. Gordon Moore MD
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