Don't overlook vaccines in value-based benefit design

September 14, 2016

A new study highlights why vaccination costs should be a top consideration when evaluating benefit offerings.

A new study highlights the implications of patients’ noncompliance with the use of in-network providers for immunization services and could be leveraged for value-based benefits design to promote access to recommended vaccinations.

The study, published in the American Journal of Pharmacy Benefits, which examined abandonment rates and factors for abandonment in patients receiving the shingles vaccine, Zostavax, at Walgreens, found that abandonment rates varied by patient demographics and health plan characteristics. Zostavax is a vaccine approved to prevent shingles in adults aged 50 years and older.

The study also found that patient out-of-pocket costs remained a significant predictor of abandonment rates, even after adjusting for patient demographics and plan characteristics.

This retrospective claims analysis and econometric model utilized data from almost 200,000 patients, aged 50 years and older, who requested a prescription fill for a Zostavax vaccine at the community pharmacy in October 2014. The vaccine was considered abandoned if there was no evidence of it being administered to the patient within 30 days of the fill date. The outcome of interest was abandonment rate, and how this rate varied by patients’ demographics (age, gender, and region), health plan characteristics, and out-of-pocket costs.

During the study period, the findings show an overall abandonment rate of 38.9%. Abandonment rate varied by patient demographics and health plan factors, but patient out-of-pocket cost remained the most significant predictor of abandonment, after adjusting for other factors, according to the authors.

“Our findings highlight the implications of patients’ noncompliance with the use of in-network providers for immunization services, as specified under the Affordable Care Act, and could be leveraged for value-based benefits design that lower patient out-of-pocket costs in order to promote access to recommended vaccinations,” says lead study author Osayi Akinbosoye, PhD, PAHM, senior manager of pricing, global insights, Walgreens.

“Consider patient out-of-pocket costs when creating and implementing a value-based benefits design leveraging your pharmacy network to promote access and compliance with recommended vaccinations,” Akinbosoye says.

According to the CDC, almost one in three people in the United States will develop shingles during their lifetime.