Childhood Vaccines Cause Financial Burden to Many Healthcare Providers

The costs that healthcare providers are charged and reimbursed for childhood vaccines vary widely, and the high cost of some immunizations is leading to significant financial strain for some physicians, according to a pair of new studies from the University of Michigan Health System.

The findings suggest that many physicians appear to be paying too much and receiving too little reimbursement, but they can use this new data to help improve both areas, the researchers say.

"Physicians need to be better business people, and negotiate better prices and payments," says lead author Gary L. Freed, MD, MPH, chief of the Division of General Pediatrics and director of the Child Health Evaluation and Research (CHEAR) Unit at the U-M Health System's Mott Children's Hospital. Freed is the immediate past chair of the U.S. Department of Health and Human Services' National Vaccine Advisory Committee.

With vaccines for children enrolled in Medicaid funded by the public sector through the federal Vaccines for Children Program, prices are negotiated annually with vaccine manufacturers by the Centers for Disease Control and Prevention (CDC). But the data from the new studies support the belief that costs and reimbursements are widely variable in private practices.

"Until now, nobody knew what anyone was paying," Freed notes. "This information will change the way in which physicians negotiate prices." The studies appear in the December issue of the journal Pediatrics.

The studies found that the price-per-dose of one brand of hepatitis B vaccine, for example, ranged from $4.26 to $13.06 at different medical practices. Reimbursements of the MMR (measles, mumps and rubella) vaccine ranged from $16.77 to $59.02. Many physicians in the survey expressed dissatisfaction with the price and reimbursement levels of vaccines.