Medicare Monday: Helping beneficiaries access vaccines

Last month, we released a State of Vaccines report, as well as an update to our Medicines in Development for Vaccines report, which shared exciting information about the 264 vaccines currently in development by America’s biopharmaceutical companies. These include vaccines for Alzheimer’s disease, which in 2016 cost Medicare an average of $23,497 in annual per-person payments for beneficiaries with Alzheimer’s or other dementias.

Continued progress in the development of new vaccines is great news for Americans of all ages, especially seniors who experience age-related changes to their immune response, called immunosenescence. This can affect their ability to fight infections, increasing the importance of vaccination for illnesses like the flu, whooping cough and shingles.

Each year, the Centers for Disease Control and Prevention’s Advisory Committee for Immunization Practices provides recommendations on vaccines and stresses their importance. Estimates show that following the full immunization schedule from birth saves 33,000 lives and $33.4 billion in indirect health care costs, yet adult vaccination rates for the most commonly recommended vaccines are low.

For seniors, Medicare Part D helps provide access to these critical vaccines. Unfortunately, some Part D plans require seniors to pay a copay for certain vaccines – like shingles and Tdap. That’s one of the reasons since 2012 the Centers for Medicare & Medicaid Services has encouraged Part D plans to offer either $0 or low cost sharing for vaccines to help increase adult immunization rates.

Research has shown that higher beneficiary out-of-pocket costs for vaccines lead to a lower chance of vaccination, but on the flip side, research has also shown that immunization rates go up when costs are eliminated.

Strengthening seniors’ access to vaccines is critically important to increasing immunization rates and preventing diseases. CMS should continue to encourage Part D plans to lower beneficiary cost sharing for vaccines.

Learn more about Medicare Part D here, and read the 2017 State of Vaccines report and updated 2017 Medicines in Development for Vaccines report.