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Health Insurers Unite Against Flu

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NU Online News Service, Dec. 15, 2003, 11:59 a.m. EST – U.S. health insurers have responded to a looming shortage of injectable influenza vaccine by agreeing to cover the new FluMist Intranasal Flu Vaccine.[@@]

The vaccine, produced by MedImmune Inc., Gaithersburg, Md., has a retail price of about $60. The U.S. Food and Drug Administration has approved it for use only for healthy individuals between the ages of 5 and 49.

Traditional flu shots are much cheaper. Doctors can give flu shots to a much wider range of patients, and the medical community has far more information about the effects and side effects of the shots than about the effects and side effects of the nasal spray.

Health experts are not even sure whether the current batch of injectable or nasal-spray vaccines can do much to stop the Fujian strain of flu, because the 2003-2004 vaccines are designed to prevent other flu strains.

But the manufacturers of the 2003-2004 U.S. flu shots say they have run out of inventory, and health systems in some regions report that they are running low on flu shots.

Some health insurers that have responded to the shortage by agreeing to cover the FluMist vaccine for at least the 2003-2004 flu season include Aetna Inc., Hartford; AmeriHealth, Mount Laurel, N.J.; Anthem Inc., Indianapolis; Blue Cross and Blue Shield of Minnesota, Eagan, Minn.; Blue Cross and Blue Shield of North Carolina, Chapel Hill, N.C.; CIGNA Corp., Philadelphia; Group Health Inc., New York; Highmark Blue Shield, Camp Hill, Pa.; Horizon Blue Cross Blue Shield, Newark, N.J.; Medica Health Plans, Minnetonka, Minn.; Oxford Health Plans Inc., Norwalk, Conn.; PacifiCare Health Systems Inc., Cypress, Calif.; and Principal Financial Group Inc., Des Moines, Iowa.

UnitedHealth Group Inc., Minnetonka, Minn., began covering the FluMist vaccine before the flu season began.

In a typical year, flu infects about 50 million U.S. residents. One in 500 of the patients who contract the flu enter the hospital, and 1 in 3 of the patients who enter the hospital with the flu die.

This year, the flu has not reached epidemic levels, but it has hit early and hard, according to the U.S. Centers for Disease Control and Prevention. The flu and a common complication of the flu, pneumonia, accounted for 7% of all deaths reported during the week ending Dec. 6 through the CDC’s 122 Cities Mortality Reporting System.

Adding temporary coverage for the FluMist vaccine will “enable more members to be vaccinated against influenza,” Aetna says in a statement about its decision to cover the nasal spray. “In addition, this also will allow the medical community, and state and local public health officials, to redirect limited supplies of the injectable influenza vaccine to those individuals in high-risk categories.”

In a similar statement, CIGNA says it is covering FluMist mainly because of CDC recommendations that health care organizations help steer healthy individuals between the ages of 5 and 49 to the nasal spray, so that public health authorities will have enough flu shots to help young children and older adults who are at high risk of dying from the flu and are not eligible to use the nasal spray.


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