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Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population

Herpes zoster (HZ) vaccination is approved for adults aged 50+ for the prevention of HZ, but it is underutilized. The objective of this study was to evaluate the association between out-of-pocket cost and HZ vaccine utilization. Adults aged 65 or older enrolled for at least 12 months in Medicare Adv...

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Autores principales: Tao, Zhuliang, Li, Yong, Stemkowski, Stephen, Johnson, Kelly D., Acosta, Camilo J., Zhang, Dongmu, Fendrick, A. Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313857/
https://www.ncbi.nlm.nih.gov/pubmed/30469449
http://dx.doi.org/10.3390/vaccines6040078
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author Tao, Zhuliang
Li, Yong
Stemkowski, Stephen
Johnson, Kelly D.
Acosta, Camilo J.
Zhang, Dongmu
Fendrick, A. Mark
author_facet Tao, Zhuliang
Li, Yong
Stemkowski, Stephen
Johnson, Kelly D.
Acosta, Camilo J.
Zhang, Dongmu
Fendrick, A. Mark
author_sort Tao, Zhuliang
collection PubMed
description Herpes zoster (HZ) vaccination is approved for adults aged 50+ for the prevention of HZ, but it is underutilized. The objective of this study was to evaluate the association between out-of-pocket cost and HZ vaccine utilization. Adults aged 65 or older enrolled for at least 12 months in Medicare Advantage/Part D (MAPD) and Medicare Part D only (PDP) plans from 1 January 2007 to 30 June 2014 were selected. Abandonment was defined as a reversed claim for HZ vaccine with no other paid claim within 90 days. Out-of-pocket costs used were actual amounts recorded in the claim. Overall, the HZ vaccine abandonment rate was 7.3%. Mean out-of-pocket costs were higher for individuals who abandoned versus those who did not ($88 (±$55) versus $80 (± $49)). Logistic regression indicated individuals with out-of-pocket costs of $80–$90 were 21% more likely (OR = 1.21, 1.16–1.27 95% CI), and those with out-of-pocket costs >$90 were 90% more likely (OR = 1.90, 1.85–1.96 95% CI) to abandon than those with out-of-pocket costs <$80. The models also suggested that socioeconomic, racial, and ethnic disparities in vaccine abandonment existed. Different vaccine targeting efforts and pharmacy benefit design strategies may be needed to increase use, improve adherence, and minimize disparities.
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spelling pubmed-63138572019-01-07 Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population Tao, Zhuliang Li, Yong Stemkowski, Stephen Johnson, Kelly D. Acosta, Camilo J. Zhang, Dongmu Fendrick, A. Mark Vaccines (Basel) Article Herpes zoster (HZ) vaccination is approved for adults aged 50+ for the prevention of HZ, but it is underutilized. The objective of this study was to evaluate the association between out-of-pocket cost and HZ vaccine utilization. Adults aged 65 or older enrolled for at least 12 months in Medicare Advantage/Part D (MAPD) and Medicare Part D only (PDP) plans from 1 January 2007 to 30 June 2014 were selected. Abandonment was defined as a reversed claim for HZ vaccine with no other paid claim within 90 days. Out-of-pocket costs used were actual amounts recorded in the claim. Overall, the HZ vaccine abandonment rate was 7.3%. Mean out-of-pocket costs were higher for individuals who abandoned versus those who did not ($88 (±$55) versus $80 (± $49)). Logistic regression indicated individuals with out-of-pocket costs of $80–$90 were 21% more likely (OR = 1.21, 1.16–1.27 95% CI), and those with out-of-pocket costs >$90 were 90% more likely (OR = 1.90, 1.85–1.96 95% CI) to abandon than those with out-of-pocket costs <$80. The models also suggested that socioeconomic, racial, and ethnic disparities in vaccine abandonment existed. Different vaccine targeting efforts and pharmacy benefit design strategies may be needed to increase use, improve adherence, and minimize disparities. MDPI 2018-11-21 /pmc/articles/PMC6313857/ /pubmed/30469449 http://dx.doi.org/10.3390/vaccines6040078 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tao, Zhuliang
Li, Yong
Stemkowski, Stephen
Johnson, Kelly D.
Acosta, Camilo J.
Zhang, Dongmu
Fendrick, A. Mark
Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title_full Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title_fullStr Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title_full_unstemmed Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title_short Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population
title_sort impact of out-of-pocket cost on herpes zoster vaccine uptake: an observational study in a medicare managed care population
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313857/
https://www.ncbi.nlm.nih.gov/pubmed/30469449
http://dx.doi.org/10.3390/vaccines6040078
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