How Does Pharmacy Benefit Coverage Impact Vaccination Rates?

Article

Adults who receive vaccination reimbursement through an employer-sponsored pharmacy insurance benefit may be more likely to receive vaccinations, according to data revealed in a poster presentation at the American Pharmacists Association (APhA) 2017 Annual Meeting & Exposition in San Francisco.

Adults who receive vaccination reimbursement through an employer-sponsored pharmacy insurance benefit may be more likely to receive vaccinations, according to data revealed in a poster presentation at the American Pharmacists Association (APhA) 2017 Annual Meeting & Exposition in San Francisco.

Although pharmacy-based immunization can positively impact adult vaccination rates, rates continue to fall below Healthy People 2020 goals. The researchers aimed to compare vaccination rates for herpes zoster vaccine (HZV) and pneumococcal vaccine (PCV) between commercially insured members with vaccine coverage via both medical and pharmacy benefits versus medical benefit only.

The researchers conducted a parallel analysis for HZV and PCV vaccination rates over a 3-year period. The study examined health plan members that fell into 2 separate categories: employer groups with pharmacy benefit coverage (exposed group) and employer groups with no pharmacy benefit coverage for vaccination (unexposed group).

Among 7404 commercially insured groups, 457,631 HZV-eligible patients and 442,792 PCV-eligible patients were selected for analysis. Vaccination rates in the exposed group were significantly higher for both HZV (43.73 vaccinations per eligible person-years) and PCV (22.44 vaccinations per eligible person-years). Comparatively, vaccination rates for the unexposed group were 15.37 for HZV and 17.48 for PCV.

The results highlight an overall disparity in vaccination coverage between the 2 groups of health plan members, indicating that the added pharmacy benefit coverage may be more likely to encourage individuals to receive vaccinations.

References

Hurley LP, Lindley MC, Harpaz R, et al. Barriers to the use of herpes zoster vaccine. Ann Intern Med. 2010;152(9);555-560.

Bridges CB, Hurley LP, Williams WW, Ramakrishnan A, Dean AK, Groom AV. Meeting the challenges of immunizing adults. Vaccine. 2015 Nov 27.33:D114-D120.

Goad JA, Taitel MS, Fensterheim LE, Cannon AE. Vaccinations administered during off-clinic hours at a national community pharmacy: implications for increasing patient access and convenience. Ann Fam Med. 2013;11(5):429-436.

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