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    Cost, perception remain barriers in pharmacy-based vaccination

    Adult vaccination rates are historically low in the U.S., and both cost and access have a lot to do with it.

    Stakeholders have called for increased access, such as through pharmacy-based vaccination programs, but a new report verifies that cost is prohibitive and keeps patients from utilizing those services.

    In a new report titled, “Opportunities and Challenges of Adolescent and Adult Vaccination Administration within Pharmacies in the United States,” and published in Biomedical Informatics Insights, researchers sought to identify factors that promote or deter pharmacy-based vaccinations for teens and adults. The research team focused on human papillomavirus (HPV); tetanus, diphtheria, and pertussis (TDAP); or meningitis (meningococcal conjugate vaccine [MCV4]), influenza and pneumococcal vaccines. Three quarters of the pharmacists that participated in the study reported that vaccination rates could be increased, and that insurance coverage, patient education, and pharmacist’s time constraints were common challenges.

    Pharmacies, according to the study, may be particularly useful as a way to reach populations with limited access to a traditional physician’s office, as well as the flexibility and extended hours a pharmacy could offer.
    Study details

    The pharmacists polled in the report generally had two to three pharmacists on staff at their location to deliver vaccines in a designated area. All offered walk-in appointments, 53% allowed appointments during business hours, 38% offered mass clinics and 78% offered vaccination services at off-site locations. As far as vaccines offered, 80% of pharmacists provided the Tdap booster, 60% provided the MCV4 vaccine and 45% provided the HPV vaccine to adolescents. All 40 of the participating pharmacists offered herpes zoster. In addition, all 40 pharmacists reported administering shingles and flu vaccines to adults.

    All of the pharmacies accepted Medicare, self-pay methods, and private insurance. Another 98% accepted Medicaid, 65% accepted TriCare, and 60% participated in the Children’s Health Insurance Program (CHIP) with more than half of the pharmacists participating in the Vaccines for Children program.

    More than half of the pharmacists polled described reimbursement available to their clients as a challenge, and 57% reported that insurance reimbursements were inadequate to cover vaccine administration costs for all vaccines and insurance plans, according to the report. The time of the pharmacist administering the vaccination was often not covered or reimbursed by payers, and 53% of pharmacists said they could not determine if a patient’s insurance covered a pharmacy-administered vaccine. Another 13% of pharmacists had to refer patients to a traditional physician’s office due to reimbursement policies.

    While 78% of pharmacists reported reimbursement and insurance issues as the greatest challenge to vaccination, 43% also cited having a designated administration area and the cost of storing vaccines to be an issue and 40% said patient education was a challenge. Pharmacists reported that patient concern over uncovered costs were also a big deterrent.

    Next: The role of primary care physicians 

    Rachael Zimlich, RN
    Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare ...

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