Vaccine Marketing - Innovation and Marketing in the Pharmaceutical Industry - page 389

Vaccine Procurement by Private Purchasers

Private purchasers can procure vaccines directly from vaccine manufacturers, pur-
chasing cooperatives/buying groups, or distributors. A US study found a wide range
of prices paid by physician practices for the same vaccine product, with the difference
between the highest and lowest prices exceeding 100 % in several cases. More than
half of the practices participated in a purchasing cooperative for at least some of the
vaccines they purchased. Practices participating in purchasing cooperatives, medium
and large practices, and those located in metropolitan statistical areas (MSAs) tended
to purchase at lower prices. The average private-practice prices were higher than the
federal contract price for 20 out of 21 vaccines studied (Freed et al. 2008b ).

Vaccine Funding of Private Purchases

A vaccine which is not publicly purchased can be fully funded through private
insurance, partially funded by private insurance with cost sharing by consumers, or
funded entirely out-of-pocket by consumers.
In the US, ACIP recommendations are the main factor driving vaccine coverage
decisions for children and adolescent vaccines by private insurers in the United
States (Hunsaker et al. 2009 ). ACIP recommendations also infl uence private insur-
ance coverage of vaccines recommended for adults. However, insurance plans
require more cost sharing for adults than for children and adolescents (Orenstein
et al. 2007 ; Shortridge et al. 2011 ).
Vaccine coverage decisions by private insurers may also result from legal mandates.
For example, New York state requires that health plans cover recommended child-
hood vaccinations and that the coverage must be “fi rst dollar,” that is, deductibles,
coinsurance, or copayments cannot apply (Benatar et al. 2010 ). A key provision of
the US 201 Patient Protection and Affordable Care Act (“Affordable Care Act”)
which increases mandatory vaccine coverage is expected to reduce fi nancial barriers
to vaccinations for many consumers (Adult Immunization Working Group to the
National Vaccine Advisory Committee 2011 ; Tan 2011 ). 35

13.3.6 Vaccination Advocates and Opponents

Vaccination beliefs, attitudes, and behaviors are also infl uenced by individuals and
organizations other than the preceding types of stakeholders. Their aim can be to
promote vaccination or, on the contrary, oppose it.
HPV vaccination provides an example of pro- and anti-vaccination advocacy.
Women in Government, a US organization for elected women in state governments

35 All new health plans, and health plans that lose their grandfathered status, must provide all
ACIP-recommended vaccines delivered by an in-network provider at no cost sharing.