Impact of medical and/or pharmacy reimbursement on adult vaccination rates

Am J Manag Care. 2018 Jul;24(8 Spec No.):SP286-SP293.

Abstract

Objectives: To evaluate whether adults enrolled in commercial health insurance plans that provide reimbursement for herpes zoster vaccine (HZV) and pneumococcal vaccine (PV) through the medical and pharmacy benefits have higher vaccination rates compared with those whose health plans cover vaccines under the medical benefit alone.

Study design: Retrospective claims analysis using medical and pharmacy claims data from January 1, 2012, through December 31, 2014. Separate but parallel analyses were conducted for HZV and PV.

Methods: Previously unvaccinated patients were divided into exposed (those in employer groups with both medical and pharmacy benefits for vaccinations) and unexposed (those in employer groups that covered vaccination under the medical benefit only) cohorts.

Results: For HZV, 32,506 and 1299 patients received vaccinations in the exposed and unexposed cohorts, respectively. The vaccination rate was significantly higher in the exposed (42 vaccinations per 1000 eligible person-years) than the unexposed cohort (15 vaccinations per 1000 eligible person-years; P <.001). For PV, 16,409 and 1386 received vaccinations in the exposed and unexposed cohorts, respectively. The vaccination rate was significantly higher in the exposed (22 vaccinations per 1000 eligible person-years) than the unexposed cohort (17 vaccinations per 1000 eligible person-years; P <.001).

Conclusions: Among members with commercial health insurance, HZV and PV rates were significantly higher among those whose insurance covered vaccinations under both medical and pharmacy benefits, compared with members whose insurance covered vaccines under the medical benefit only. Pharmacy-based vaccination coverage from commercial health insurance plans may help improve adult vaccination rates.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Communicable Disease Control / economics*
  • Cost-Benefit Analysis
  • Female
  • Health Care Costs*
  • Herpes Zoster Vaccine / administration & dosage
  • Herpes Zoster Vaccine / economics*
  • Humans
  • Insurance Claim Review
  • Insurance Coverage / economics
  • Insurance, Health, Reimbursement / economics*
  • Male
  • Pneumococcal Vaccines / administration & dosage
  • Pneumococcal Vaccines / economics*
  • Retrospective Studies
  • Vereinigte Staaten
  • Vaccination / economics

Substances

  • Herpes Zoster Vaccine
  • Pneumococcal Vaccines