Group Assails Pacificare for Discouraging Use of Vaccine

A California consumer group Tuesday accused the big HMO Pacificare Health Systems of discouraging use of a new chickenpox vaccine just to save money.

Consumers for Quality Care said Pacificare’s position against Varivax--the first-ever vaccine against the disease--contradicts endorsements by federal health agencies and leading pediatricians.

“This appears to be yet another case of HMOs rewriting medical science to meet their cost-cutting goals,” said Jamie Court, a spokesman for the group, a leading critic of health maintenance organizations in California.

Pacificare, which serves 1.8 million people, mostly in California, said money has nothing to do with its position and that parents who want the vaccine for their children can have it if they ask.

The HMO said it is concerned the vaccine may wear off years after it is administered.

In most children the disease is mild, and once it’s gone, the child is immune for life, prompting doubts about whether the vaccine is really necessary, Pacificare said.

“The real issue is all of the unanswered questions about Varivax, not cost,” said Dr. William Osheroff, medical director of Pacificare’s California HMOs.

The dispute illustrates a new front in the growing national controversy over whether HMOs scrimp on high-quality medical care in order to maximize profits.

A study last month showed that HMOs that limit patient access to the newest, most powerful drugs may save money now, but are causing health-care costs to go up in the long run because these people will get sicker. HMOs deny they impose undue restrictions on drugs, contending drugs are often the most cost-effective medical treatments.

Pacificare is one of the country’s biggest and fastest-growing HMOs, with profit projected by Wall Street analysts to grow nearly 20% a year.

About 4 million Americans, mostly children, get chickenpox every year. Usually it’s just a nuisance, but in rare cases it’s serious, with about 9,300 people hospitalized each year and nearly 100 deaths.

Varivax, developed by Merck & Co. of Whitehouse Station, N.J., was approved by the Food and Drug Administration a year ago.