Reimbursement for HPV Vaccine Cost in the Private Sector: A Comparison Across Specialties.

Zhu, Yenan; Lin, Yueh-Yun; Li, Ruosha; He, Cara; Lairson, David R; Deshmukh, Ashish A; Sonawane, Kalyani · Ann Fam Med · 2023

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Abstract

The human papillomavirus (HPV) vaccine is the most expensive of all routinely recommended pediatric vaccines. Adequate cost reimbursement by 3rd-party payers is a critical enabling factor for clinicians to continue offering vaccines. This study found that net returns from HPV vaccine cost reimbursements are lowest for family physicians ($0.34/dose) and highest for pediatricians ($5.08/dose). Furthermore, a $1 increment in return was associated with an increase in HPV vaccine doses administered (highest for family physicians; 0.08% per dollar). Reimbursement for HPV vaccine costs by private payers is adequate; however, return margins are small for non-pediatric specialties.

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