Yan Songkai, DerSarkissian Maral, Bhak Rachel H, Lefebvre Patrick, Duh Mei Sheng, Krishnarajah Girishanthy
a GSK, US Health Outcomes & Epidemiology - Vaccines , Philadelphia , PA , USA.
e Current affiliation: CSL Behring , King of Prussia , PA , USA.
Curr Med Res Opin. 2018 Jul;34(7):1261-1269. doi: 10.1080/03007995.2017.1416347. Epub 2018 Jan 10.
To assess the relationship between copay amount and vaccination claim submission status for tetanus-diphtheria-acellular pertussis (Tdap) and herpes zoster (GSK study identifier: HO-14-14319).
Retrospective analyses were performed using vaccination administrative claims data in patients aged ≥65 years with ≥1 claim for Tdap or zoster vaccines between 2012 and 2014. To avoid confounding by other financial responsibility, analyses were conducted among patients in the copayment phase of insurance. The impact of patient copay amount on vaccination claim status ("canceled" vs. "paid") was evaluated by logistic regression separately for Tdap and zoster, adjusting for patient and provider characteristics.
A total of 81,027 (39.2% with canceled claims) and 346,417 patients (56.8% with canceled claims) were included in the Tdap and zoster analyses, respectively. Mean (standard deviation) copay for canceled vs. paid claims was $37.2 (18.4) vs. $31.1 (20.1) for Tdap and $64.9 (36.9) vs. $53.5 (38.8) for zoster. The adjusted odds ratios (ORs) for a canceled Tdap vaccine claim, compared with $0 copay, were 1.19 ($1-25 copay), 1.76 ($26-50 copay), 2.42 ($51-75 copay) and 2.40 ($76-100 copay), all p < .001. The adjusted ORs for a canceled zoster vaccine claim, compared with $0 copay, were 1.02 ($1-25), 1.39 ($26-50), 1.66 ($51-75), 2.07 ($76-100) and 2.71 (>$100), all p < .001 except for $1-25 (p = .172).
High patient copay is a barrier to Tdap and zoster vaccinations in Medicare Part D patients. Providing vaccines at low or no copay may improve vaccination rates in these adults. GSK study identifier: HO-14-14319.
评估破伤风-白喉-无细胞百日咳（Tdap）疫苗和带状疱疹疫苗（葛兰素史克研究标识符：HO-14-14319）的自付费用金额与疫苗接种申请提交状态之间的关系。
利用2012年至2014年间年龄≥65岁、有≥1次Tdap或带状疱疹疫苗接种申请的患者的疫苗接种管理申请数据进行回顾性分析。为避免其他财务责任造成的混淆，在保险自付阶段的患者中进行分析。通过逻辑回归分别评估患者自付费用金额对Tdap和带状疱疹疫苗接种申请状态（“取消”与“支付”）的影响，并对患者和医疗服务提供者的特征进行调整。
Tdap分析和带状疱疹分析分别纳入了81,027名患者（39.2%的申请被取消）和346,417名患者（56.8%的申请被取消）。Tdap疫苗接种申请被取消与已支付的平均（标准差）自付费用分别为37.2美元（18.4美元）和31.1美元（20.1美元）；带状疱疹疫苗接种申请被取消与已支付的平均（标准差）自付费用分别为64.9美元（36.9美元）和53.5美元（38.8美元）。与0美元自付费用相比，Tdap疫苗接种申请被取消的调整比值比（OR）分别为：自付1-25美元时为1.19，自付26-50美元时为1.76，自付51-75美元时为2.42，自付76-100美元时为2.40，所有p值均<0.001。与0美元自付费用相比，带状疱疹疫苗接种申请被取消的调整OR分别为：自付1-25美元时为1.02，自付26-50美元时为1.39，自付51-75美元时为1.66，自付76-100美元时为2.07，自付>100美元时为2.71，除自付1-25美元外（p = 0.172），所有p值均<0.001。
高额患者自付费用是医疗保险D部分患者接种Tdap和带状疱疹疫苗的障碍。提供低自付或无自付的疫苗可能会提高这些成年人的疫苗接种率。葛兰素史克研究标识符：HO-14-14319。
