Tsai Yuping, Leung Jessica, Anderson Tara C, Zhou Fangjun, Singleton James A
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA..
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Vaccine. 2025 Jan 1;43(Pt 1):126537. doi: 10.1016/j.vaccine.2024.126537. Epub 2024 Nov 22.
The Inflation Reduction Act (IRA) eliminated cost sharing for Medicare Part D-covered vaccines but did not address the cost burden faced by Medicare beneficiaries who did not have prescription drug coverage. This study aimed to determine the characteristics of beneficiaries without prescription drug coverage and to assess the association between the receipt of a herpes zoster vaccine and prescription drug coverage status.
We used the 2019-2023 National Health Interview Survey and included Medicare beneficiaries aged 65 years and older who enrolled in both Parts A and B or a Medicare Advantage plan. Descriptive statistics were used to examine beneficiaries' characteristics. Logistic regressions were used to examine the associations between the receipt of a herpes zoster vaccine and Medicare prescription drug coverage.
The study included 33,578 beneficiaries and 93.5 % of beneficiaries had prescription drug coverage. The prevalence of lacking prescription drug coverage was higher among beneficiaries who did not have a college degree, had family income below the poverty level, had no flu shot and well visit within the past year, and had no usual place for care. The probability of receiving a herpes zoster vaccine was higher among beneficiaries with prescription drug coverage than those without prescription coverage (45.2 % versus 25.3 %).
Herpes zoster vaccination disparities between beneficiaries with and without prescription drug coverage existed before the IRA. Because the IRA only addresses the cost barrier facing by beneficiaries with prescription drug coverage, vaccination disparities was greater after the IRA implementation.
《降低通胀法案》（IRA）取消了医疗保险D部分所涵盖疫苗的费用分摊，但并未解决没有处方药保险的医疗保险受益人的费用负担问题。本研究旨在确定没有处方药保险的受益人的特征，并评估接种带状疱疹疫苗与处方药保险状况之间的关联。
我们使用了2019 - 2023年全国健康访谈调查，纳入了年龄在65岁及以上、同时参加了A部分和B部分或医疗保险优势计划的医疗保险受益人。描述性统计用于检查受益人的特征。逻辑回归用于检查接种带状疱疹疫苗与医疗保险处方药保险之间的关联。
该研究纳入了33578名受益人，93.5%的受益人有处方药保险。在没有大学学历、家庭收入低于贫困线、过去一年没有接种流感疫苗和进行健康检查、以及没有固定就医地点的受益人中，缺乏处方药保险的患病率更高。有处方药保险的受益人接种带状疱疹疫苗的概率高于没有处方药保险的受益人（45.2%对25.3%）。
在《降低通胀法案》出台之前，有和没有处方药保险的受益人在带状疱疹疫苗接种方面就存在差异。由于《降低通胀法案》仅解决了有处方药保险的受益人面临的费用障碍，该法案实施后，疫苗接种差异更大。
