Some Physicians Consider Ending Vaccinations Because Of Low Reimbursements, Studies Find

Main Category: Immune System / Vaccines
Also Included In: Primary Care / General Practice
Article Date: 02 Dec 2008 - 4:00 PDT

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About one in 10 physicians who provide vaccinations for privately insured children are considering dropping the services because reimbursements are too low, according to a survey published in the December issue of the journal Pediatrics, the AP/Philadelphia Inquirer reports. The study, based on a 2007 mail-in survey to which 800 pediatricians and family physicians responded, found that about half of the physicians had delayed purchasing at least one vaccine because of cost and about one in five said they felt strongly that their reimbursement for the purchase and administration of vaccines was inadequate.

A separate survey of 76 physicians in five states found significant disparities between costs and reimbursement rates. The survey examined the costs of the vaccines and storage but it did not look at administrative fees, staff time or vaccinations paid for by the federal government. For example, for one recommended infant vaccine, one in 10 physicians lost money while others profited nearly $40 per dose, and for a pneumococcal disease vaccine, per-dose difference ranged between a $40 profit and an $11 loss. Gary Freed of the University of Michigan, a co-author of both studies, said, "Many physicians really weren't aware they were getting reimbursed so little."

However, the AP/Inquirer reports that most pediatricians likely will continue providing the vaccines. According to the AP/Inquirer, the studies show that overall about 11% of physicians have seriously considered ending vaccinations for privately insured patients, compared with 21% of family physicians and 5% of pediatricians. Pediatrician Herschel Lessin said, "For us to give up vaccines would hurt our core business because that's why kids come in."

Experts say there is no evidence that large numbers of physicians have stopped giving vaccines because of financial problems, but health officials are concerned that as physicians face increasing economic pressures and more parents forgo vaccinations for children, larger outbreaks of certain diseases, such as measles, could occur in the future. Lance Rodewald of CDC said the two studies are "a very important wake-up call" (Stobbe, AP/Philadelphia Inquirer, 12/1).

An abstract of the first study is available online. An abstract of the cost study also is available online.

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