With more reports of non-travel related Zika cases popping up in the U.S., state Medicaid agencies are preparing to spend millions to prevent spread of the virus. But some experts say that money could be better spent elsewhere.
In the past few weeks, Louisiana, Texas, Pennsylvania, Mississippi, Ohio and Virginia have all said they plan to cover mosquito repellent in an effort to prevent contraction of the virus. Delaware has posted a proposed rulemaking to do the same.
Texas officials believe they may spend as much as $12.6 million in federal and state funding as a result of the new coverage. Louisiana estimates it will spend more than $5 million. The other states did not immediately respond to requests for cost projections.
Earlier this summer, the CMS granted states permission to cover (PDF) repellents if they were prescribed by an authorized health professional.
Advocates and providers called the coverage critical to decreasing the chances of transmission among lower income people who already are more at risk for contracting the virus, according to Georges Benjamin, executive director of the American Public Health Association. Zika causes a mild illness in most people but can lead to severe brain-related birth defects if women are infected during pregnancy.
“When living paycheck to paycheck, mosquito repellent is just like medication. Necessary, but discretionary over rent, food and transportation to get to work,” Benjamin said.
Low-income individuals are more likely to get infected with Zika because they may live in homes without air conditioning or window screens, or may have jobs outdoors — all factors which make them more likely to get bitten by mosquitoes, said Dr. Sylvia Becker-Dreps, associate professor in the department of family medicine at the University of North Carolina School of Medicine.
However, of the 2,260 cases of Zika confirmed so far in the U.S., only 14 were acquired within the country, according to the Centers for Disease Control and Prevention.
Some experts say the repellent coverage might not be well thought out.
“The vast majority of the U.S. population is at very low risk for acquiring Zika infection in the absence of travel, thus, as a generalization, any widespread prevention spending on individual Medicaid consumers will bring mostly cost and little efficacy,” said Dr. Matt Collins, an infectious diseases fellow at UNC School of Medicine's Division of Infectious Diseases.
The coverage decision comes at a time when costs of the products are increasing. For instance, the price of Off Deep Woods brand spray averaged $6.52 per unit, up 33 cents from the previous year according to Market researcher IRI, which tracks sales in brick-and-mortar retail stores in the U.S. The average price for bug spray purchased online has jumped to $12.66, up 23% over the last year, according to data analytics firm 1010data.
Overall, Americans have spent nearly $62 million on insect repellent this year, up 12% from a year ago, according to IRI.