Problematic pharmacy benefit managers can limit patient access and disrupt the vaccine supply. Pharmacists can increase vaccine uptake.
New Study Shows Increase in Pharmacy Reimbursement Leads to Higher Adult Medicaid Flu Vaccination Rates
PRESS RELEASE
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New Study Shows Increase in Pharmacy Reimbursement Leads to Higher Adult Medicaid Flu Vaccination Rates
PUBLISHED 2/27/24
GHLF STAFF
FOR IMMEDIATE RELEASE
MEDIA CONTACT
Susan Jara
Phone: 201-406-7756
Email: [email protected]
UPPER NYACK, NY — The Global Healthy Living Foundation (GHLF) co-released a groundbreaking report that found a direct link between pharmacy reimbursement and flu vaccination rates among Medicaid-covered adults.
This report was commissioned by GHLF and the IQVIA Institute for Human Data Science to better understand the correlation between equitable compensation for pharmacists and enhanced vaccination rates for this vulnerable population.
According to co-researcher Vibhu Tewary, Project Director, IQVIA Institute for Human Data Science, “a $13 increase in pharmacy reimbursement for adult flu vaccination was associated with a nearly 6 percent point surge in the state vaccination rate for Medicaid fee-for-service covered adults.”
To put it in perspective, a mere $1 increment in Medicaid fee-for-service pharmacy reimbursement for adult flu vaccines translates to a half-percentage-point boost in vaccination rates. Currently, pharmacy reimbursement averages around $12, considerably lower than Medicare’s $30.
“Pharmacists play a crucial role in immunization efforts in the U.S. and globally; now is the time to ensure state policies adequately compensate pharmacies for vaccine administration,” said co-author Robert Popovian, PharmD, Chief Science Policy Offer at the Global Healthy Living Foundation (GHLF). “These actions can be a crucial step toward improving vaccination rates for Medicaid enrollees.”
Adults under Medicaid coverage often face significant disparities in vaccination rates compared to individuals with commercial insurance or Medicare coverage. Previous studies have underscored these disparities, with an 8 to 11 percent gap in flu vaccination rates between Medicaid and commercial populations and a staggering nearly 30 percent difference between Medicaid and Medicare populations.
While this report focused on flu vaccines, the study’s results spotlight the potential for enhancing vaccination access by empowering pharmacists to offer a broader range of vaccinations while ensuring fair reimbursement. This approach promises to significantly increase vaccination access for families with limited resources.
Research consistently shows that broadening pharmacy vaccination authority will increase immunization rates, reduce healthcare costs, and save lives. Previously shared Global Healthy Living Foundation studies have shown that pharmacies have more locations and longer operating hours than physician practices in low-income communities, further highlighting the critical function pharmacies play in expanding vaccination services.
“The improved reimbursement for pharmacists to administer the flu vaccine for Medicaid patients is an essential step in addressing health disparities as it pertains to low-income communities where pharmacies are far more accessible than physician offices and where racial and ethnic minorities are overrepresented,” said Dr. Popovian.
This report was supported by Pfizer and produced independently by the IQVIA Institute for Human Data Science in partnership with the Global Healthy Living Foundation (GHLF).
About the IQVIA Institute for Human Data Science
The IQVIA Institute for Human Data Science contributes to the advancement of human health globally through timely research, insightful analysis, and scientific expertise applied to granular non-identified patient-level data.
Fulfilling an essential need within healthcare, the Institute delivers objective, relevant insights, and research that accelerate understanding and innovation critical to sound decision making and improved human outcomes. With access to IQVIA’s institutional knowledge, advanced analytics, technology, and unparalleled data, the Institute works in tandem with a broad set of healthcare stakeholders to drive a research agenda focused on Human Data Science, including government agencies, academic institutions, the life sciences industry, and payers. More information about the IQVIA Institute can be found at www.IQVIAInstitute.org.
GHLF’s Patient-Focused Economic and Policy Research Division
At the Global Healthy Living Foundation, the Patient-Centered Economic and Policy Research Division conducts original research focused on health policy economics and outcomes research to better understand how current and proposed health policies, regulations, and legislation affect patients’ financial, healthcare, quality-of-life, and other outcomes. We aim to increase transparency and understanding of the public health policies, regulations, and legislation impacting chronic disease patient communities by sharing our research via publication, our website, social media platforms, and conventional media. Our researchers also address these important topics through opinion editorials, speaking engagements, and our world-class podcast series – Healthcare Matters. Our experts have published extensively on the impact of biopharmaceutical and health policies on costs and clinical outcomes in the most prominent medical sources and media publications. They are sought-after speakers, providing briefings and expert reviews for the U.S. Congress, dozens of state legislatures, and at conferences and medical symposiums around the world. Learn more at https://ghlf.org/our-work/economic-policy-research/.
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