Reimbursement for HPV Vaccine Cost in the Private Sector: A Comparison Across Specialties

Article Figures & Data

Table 1.

HPV Vaccine Reimbursement by Private Payer Across Clinician Specialties, 2017-2018

Measure	Clinician Specialty
Measure	Pediatrician n = 20,484	Family Physician n = 9,342	Internal Medicine Specialist n = 852	Nurse Practitioner n = 2,339	Other n = 1,230
HPV vaccine reimbursement, mean (SD)^{^a}	$216.07 ($8.53)	$211.33^{^c} ($16.80)	$212.97^{^c} ($14.70)	$212.91^{^c} ($14.74)	$213.29^{^c} ($14.17)
Net return per dose, mean (SD)^{^b}	$5.08 ($8.53)	$0.34 ($16.80)	$1.98 ($14.70)	$1.92 ($14.74)	$2.30 ($14.17)

AAP = American Academy of Pediatrics; CDC = Centers for Disease Control and Prevention; HPV = human papillomavirus vaccine.
↵a HPV vaccine reimbursement was calculated as the dollar amount paid for the HPV vaccine cost to the clinician by the insurer.
↵b In 2017-2018, the CDC recommended pricing per HPV vaccine dose for the private sector was $210.99. Recommended vaccine purchase reimbursement and immunization incentive by the AAP is 125% ($263.74) of the CDC vaccine price list for the private sector.
↵c P <0.05 for the Kruskal-Wallis post hoc test compared with pediatricians.

Table 2.

Association Between Net Return Per Dose and HPV Vaccine Doses Administered, 2017-2018

CDC = Centers for Disease Control and Prevention; HPV = human papillomavirus vaccine.
a Independent variable was net incentives earned per dose, calculated as the difference between HPV vaccine cost reimbursement and the CDC list price. The dependent variable was the proportion of HPV vaccine visits (ie, the number of visits the HPV vaccine was administered divided by the total number of preventive care visits times 100). Linear regression models were constructed for each specialty adjusting for the proportion of visits by female and urban adolescents and weighted for the number of preventive care visits.
↵b Statistically significant at P <0.05.