Over the last decade, there has been an upsurge of new vaccines in the
Indian market. The Indian Academy of Pediatrics Committee on
Immunization (IAPCOI) recommends vaccination schedule for ‘office
practice’ annually, which serves as a guideline for pediatricians across
the country. From ‘optional’ to ‘one is to one discussion with parents’
there has been a major shift to ‘routine vaccines’ and ‘special
circumstances’ vaccination. This has led to a vertical split between the
public- and the private-sector vaccination program.
It has been our observation that a new vaccine is
usually launched at a higher price, that is then slashed within months
once another manufacturer steps in. Further, by altering or adding
another component to the vaccine, the cost of such combination far
exceeds the cost when given individually. This is aptly being reflected
in the newly launched six-in-one combinations. Also it is observed that
individual vaccine by the same company goes out of market once a new
vaccine is launched but continues to be available in combination (eg,
Inactivated polio vaccine). This leads to an unjustified increase in the
overall cost of vaccination, thus pinching the pockets of the parents.
The vaccine pricing recently has created headlines in
national print media holding the pediatricians responsible. This is
unfortunate as it has led to a growing mistrust between the doctor and
the parents. It is very clear that doctors have no say in the pricing of
the vaccine, and ‘MRP’ is decided by the vaccine manufacturer.
Cardiology stents and orthopedic implants have come
under radar for over-pricing. Government of India has recently
introduced regulation for fair pricing for essential drugs. This should
be extended to the vaccine sector to curb the growing price menace. It
is indeed tragic that the vaccination has become a ‘privilege’ rather
than an essential right of the child. Parents feel guilty of not
affording the newer vaccines and pediatricians usually have to take the
blame little realizing that they end up serving as pawns at the hands of
giant multinationals. As custodians of our children, we must ensure that
the vaccine use is based on the intent, content and science, and raise
voice against the pricing mischief. All the stakeholders should
advocate, support and promote a ‘fair pricing’ policy for the vaccines
for the well being of all our future citizens.