Approved Minutes of October 25, 2023

Browse Search

MINUTES-Draft ORANGE COUNTY BOARD OF HEALTH October 25, 2023 Dr. Royce asked if there are specific guidelines for attendance for the chair and vice chair, to which Dr. Jonnal responded no. Mr. Bagby added that sometimes one may run late, citing last month's meeting when Dr. Jonnal served as chair in his place because he had expected to have a conflict, but if both are running late this could present a problem. Dr. Stuebe joked that both she and Dr. Jonnal are public health people trapped in physician's bodies, so she is not worried that they will get too medical, plus Ms. Stewart will be able to help them remain in a broad view. When Mr. Bagby called for any other nominations, none were put forth. Motion to approve the Chair and Vice Chair Slate with the nominations of Dr. Jonnal for 2024 Chair and Dr. Stuebe for 2024 Vice Chair was made by Mr. Tony Whitaker, seconded by Dr. Lee Pickett, and carried without dissent. B. Fee Schedule Amendment Request Ms. Stewart presented the proposed fee changes to the board. Ms. Stewart explained that the cost for these vaccines were included in the fee schedule approved in February, but that the prices they were initially given by the manufacturer were incorrect by as much as $385.35 (underquoted as $99.75 instead of$485.10 per dose). The proposed fee changes are as follows: • CPT Code 90380 - RSV, monoclonal antibody, seasonal dose, 0.5 mL dosage for intramuscular— Beyfortus - $485.10 • CPT Code 90381 - RSV, monoclonal antibody, seasonal dose, 1.0 mL dosage for intramuscular— Beyfortus -$485.10 • NEW- CPT Code 90678 - ABRYSVO (Respiratory Syncytial Virus vaccine, preF, subunit, bivalent, for intramuscular use) 0.5 mL solution for intramuscular injection -$292.05 Ms. Stewart added that the existing COVID-19/Communicable Disease (CD) relief funds have been used to purchase these vaccines, which means these vaccines are provided to patients at no charge. However, when Dr. Crandell asked how long these funds would last, she explained that these funds are limited and will likely not be enough to cover another large order. In response to Dr. Crandell's question as to whether the doses that were purchased using COVID/CD relief funds could be set aside for un/under insured patients, Ms. Stewart explained that the State currently has an allocation of vaccines for this population via the Bridge and VFC programs. The health department will continue to ensure that individuals who want these vaccines regardless of their insurance status, will be able to get them. Dr. Crandell expressed concern that the department might use up all the free doses on people with insurance. Dr. Stuebe asked if these vaccines are particularly expensive to manufacture and/or develop — Dr. Crandell responded that he couldn't say definitively, as he was not involved in the development of these vaccines, but that most new drugs are expensive and drug pricing is a controversial topic right now. Dr. Jonnal pointed out that in many cases, the exact same medicine is made available in countries outside the USA at a fraction of the cost. In response to Dr. Royce's question about how the prices are negotiated, Ms. Stewart explained that they are set by the manufacturer and the health department is not able to negotiate pricing. Dr. Jonnal compared this to a monopoly situation. For comparison, Dr. Royce asked how much S:\Managers Working Files\BOH\Agenda&Abstracts\2023 Agenda&Abstracts/ October Page 6