Nonpediatric Specialties Face Smaller Return Margins for HPV Vaccine Costs

MONDAY, July 31, 2023 (HealthDay News) -- For nonpediatric specialties, return margins for human papillomavirus (HPV) vaccine costs by private payers are small, according to a study published in the July/August issue of the Annals of Family Medicine.

Yenan Zhu, Ph.D., from the Medical University of South Carolina in Charleston, and colleagues compared HPV vaccine cost reimbursement by the private sector across provider specialties in a nationwide sample of HPV vaccine-eligible adolescents. The number of HPV vaccine doses administered by each of 34,247 clinicians was examined during 2017 to 2018, and reimbursement was calculated as the amount paid by the insurer to clinicians to cover the cost of vaccine purchase.

HPV vaccine cost reimbursement was at or above the U.S. Centers for Disease Control and Prevention list price, but was below the recommendations of the American Academy of Pediatrics. The researchers found that net returns from HPV vaccine cost reimbursements were lowest ($0.34/dose) and highest ($5.08/dose) for family physicians and pediatricians, respectively. A $1 increase in return was associated with an increase in HPV vaccine doses administered (0.08 percent for family physicians, 0.06 percent for "other" specialties, and 0.05 percent for pediatricians).

"Family physicians -- who are so critical and important, especially in rural areas where not all patients have access to pediatricians -- are not receiving adequate reimbursement for the HPV vaccine, which is sort of a disincentive for them to offer this critical cancer-preventive vaccine," coauthor Kalyani Sonawane, Ph.D., of the MUSC Hollings Cancer Center in Charleston, said in a statement.

Financial relationships with Merck and Value Analytics Labs were reported.

Abstract/Full Text