PMID: 30020746Jul 19, 2018Paper

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

The American Journal of Managed Care
Gaurav DeshpandeKelly D Johnson

Abstract

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. 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. 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. 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 ...Continue Reading

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