By: Susan Kreimer
06 December 2010
Poor reimbursement may hinder pediatricians from using combination vaccines in their practices, a new national survey suggests.
The study appears in the December issue of the Archives of Pediatrics & Adolescent Medicine
More than half of survey participants said their practices did not receive adequate reimbursement for the purchase and administration of vaccines. About 20% of respondents indicated that insufficient compensation has prevented them from giving at least 1 combination vaccine.
Under fee-for-service contracts, physicians typically collect a separate payment for each injection. When a combination vaccine substitutes for 2 or more injections with a single shot, physicians may lose revenue.
Physicians also receive another fee to cover the purchase of each vaccine. Combination vaccines are generally more expensive than equivalent component vaccines. For instance, the combination vaccine DTaP-IPV/Hib (diphtheria, tetanus, pertussis, polio, and Hib [Haemophilus influenzae type b]) sells for about $73 in the private sector, whereas the costs of DTaP, IPV, and Hib vaccines add up to $66.
Designed to reduce the number of injections in routine childhood immunizations, new combination vaccines have been introduced in the last several years. Factors influencing combination vaccine usage include physician practice size and the proportion of children whose immunizations are paid for by public funds.
“This lack of uniformity is a problem, because in the context of an increasingly more complex set of national vaccine recommendations for newborns to 6-year-olds, combination vaccines help children get vaccinated in a more timely fashion,” Matthew M. Davis, MD MAPP, from the University of Michigan, in Ann Arbor, writes in an editorial accompanying the study.
Although insufficient reimbursement leads to loss of income for some pediatricians, it reduces the profit margin for others. Pediatricians may set a relatively low bar for adequacy of reimbursement, as about half of those surveyed said practices should offer combination vaccines even if it meant sacrificing revenue.