Shingles Vaccinations Increased Following Patient Out-of-Pocket Cost Removal

The Inflation Reduction Act (IRA) eliminated cost sharing for vaccines covered by Part D beginning in January 2023 to improve the affordability of vaccines for Medicare beneficiaries.

To help determine if the impact matches the IRA's intent, a team led by Dima Qato—Hygeia Centennial Chair and Associate Professor at the USC Mann School of Pharmacy and Pharmaceutical Sciences—evaluated the policy removing patient out-of-pocket costs for the uptake of shingles vaccinations, the most commonly administered vaccine covered by Part D.

A Research Letter published by the JAMA Network evaluated the association of this zero cost-sharing policy on the use of shingles vaccinations, which account for more than 90% of Part D vaccinations.

Following the implementation of the new policy, total Part D shingles vaccinations dispensed increased by 46%.

Between January 2022 and December 2023, 16.3 million shingles vaccines (8.3 million to individuals with Part D and 8 million to those with commercial insurance) were dispensed at retail pharmacies.

These researchers wrote, 'The implementation of the IRA policy eliminating out-of-pocket costs for Part D–covered vaccinations was associated with substantial increases in shingles vaccinations dispensed to Part D enrollees compared with commercially insured individuals at retail pharmacies.'

"Policy matters," said Qato in a press release on May 23, 2024, who also directs the Mann School's Program on Medicines and Public Health and is a senior fellow at the USC Schaeffer Center for Health Policy & Economics. "And when these policies eliminate the costs, they remove barriers in accessing essential medications and preventive services, including vaccinations."

Recently, a long-term study revealed that the leading shingles vaccine delivers extensive value.

In April 2024, GSK plc announced that data from a long-term follow-up phase III trial showed that the Shingrix® vaccine, also known as Recombinant Zoster Vaccine, remained effective against shingles for more than a decade in adults over 50.

As of May 24, 2024, the Shingrix vaccine is available at most pharmacies in the U.S.