Insurance reimbursements for recombinant zoster vaccine in the private sector

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Leidner, Andrew J. ; Tang, Zhaoli ; Guo, Angela ; Anderson, Tara C. ; Tsai, Yuping
• Description:
  A two-dose series of the recombinant zoster vaccine (RZV, Shingrix) was licensed by the Food and Drug Administration in 2017 and recommended by the Advisory Committee on Immunization Practices in 2018 for adults in the United States age 50 years and older. Despite the health benefits of shingles vaccination, coverage has remained low, with financial barriers among healthcare providers identified as one potential factor. This study estimates the reimbursement levels for RZV among a large sample of privately insured individuals in the US from the 2018 IBM® MarketScan® Commercial Claims and Encounters database. Of 198,534 claims for an RZV dose, the mean reimbursement was $149. Most claims (83%) exceeded $140, which was the private sector vaccine price reported on the CDC vaccine price list in April 2018. These results can be useful for providers considering procuring RZV and for state immunization programs considering ways to improve vaccination coverage.
• Subjects:
  Adult Herpes Zoster Herpes Zoster Vaccine Humans Insurance Middle Aged Private Sector United States Vaccines, Synthetic
• Keywords:
  Herpes Zoster Private Insurance Recombinant Zoster Vaccine Reimbursement Shingles
• Source:
  Vaccine. 39(36):5091-5094
• Pubmed ID:
  34348844
• Pubmed Central ID:
  PMC8947845
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  39
• Issue:
  36
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a99fdad32071005054b368a7ace0194e222bb4ca5de4340835eb46c86751644c
• Download URL:
  https://stacks.cdc.gov/view/cdc/115717/cdc_115717_DS1.pdf
• File Type:
  [PDF - 70.15 KB ]