[Congressional Record Volume 154, Number 65 (Wednesday, April 23, 2008)]
[Extensions of Remarks]
[Page E708]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                INTRODUCING THE SHINGLES PREVENTION ACT

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                          HON. MAZIE K. HIRONO

                               of hawaii

                    in the house of representatives

                       Wednesday, April 23, 2008

  Ms. HIRONO. Madam Speaker, I rise today to introduce the Shingles 
Prevention Act.
  Many of us have had shingles or know of others, especially over the 
age of 60, who have. In 2006 a new vaccine was created that prevents 
occurrence of shingles or dramatically reduces the symptoms and pain of 
shingles. Experts agree that adults over the age of 60 should receive 
this immunization.
  Half of us will experience shingles by the time we are 80. Shingles 
is a painful skin rash often accompanied by fever, headache, chills, 
and upset stomach. What is more pressing is that one in five shingles 
patients will endure post-herpetic neuralgia--severe pain lasting much 
longer than the rash itself. The pain can be so intolerable that 
patients are housebound, and there have been cases of suicide from the 
disease. Shingles is most common among seniors because the immune 
system wanes with age, making Medicare beneficiaries the best 
candidates for the vaccine.
  Since its development in 2006, the shingles vaccine has been 
recommended for adults 60 years or older by the Centers for Disease 
Control. However, current Medicare Part D coverage of the vaccine is 
insufficient. Not all beneficiaries are enrolled in Part D or another 
drug prescription plan. More important, seniors are facing high out-of-
pocket costs due to a lack of coordination among doctors, pharmacies, 
and Part D plans. For example, there is no established direct billing 
method between doctors and plans for Part D vaccines. Because of this, 
beneficiaries typically must pay the full price up front, which results 
in out-of-pocket costs that limit access to those that need the vaccine 
the most--our seniors.
  The billing problem, the resulting low utilization of the vaccine, 
and costly storage requirements are enough to keep many doctors from 
stocking the vaccine. When doctors do not stock, beneficiaries' only 
alternative is to obtain the vaccine from pharmacists. But many states 
do not allow pharmacies to administer Part D vaccines, so the 
beneficiary has to take the vial from the pharmacy back to the 
physician office. Thus, a senior who is thinking about getting 
vaccinated would have to go first to the doctor's office for a consult, 
then to the pharmacist, then back to the doctor for the shot.
  Not surprisingly, many seniors are not getting immunized against 
shingles. This low utilization rate contributes to the half a billion 
dollars of treatment costs per year and, for hundreds of thousands of 
seniors, many weeks spent suffering from a disease that could have been 
prevented.
  The Shingles Prevention Act will move shingles vaccine coverage to 
Part B--thus treating it in the same manner as the flu vaccine under 
Medicare, simplifying the process for physicians and beneficiaries, and 
lessening the cost burden for our seniors. This is a common sense and 
cost effective way to increase access to high quality health care for 
our seniors, and I look forward to working with my colleagues to ensure 
its passage.

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