Insurance reimbursements for recombinant zoster vaccine in the private sector |
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Institution: | 1. National Center for Immunization and Respiratory Diseases, CDC, United States of America;2. Berry Technology Solutions, Contractor for National Center for Immunization and Respiratory Diseases, CDC, United States of America;3. Strategic Innovative Solutions, Contractor for National Center for Immunization and Respiratory Diseases, CDC, United States of America |
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Abstract: | 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. |
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Keywords: | Shingles Herpes zoster Recombinant zoster vaccine Reimbursement Private insurance |
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