Managing Costs​​​

While there are many costs associated with purchasing and administering vaccines, there are ways for pediatric offices to manage these costs in order to cover overhead.

There are various ways to purchase vaccines. They include:

  • Standard programs
    Direct purchasing access is offered by all major vaccine manufacturers. This may be an easy way to purchase vaccines, but often will not provide the best price.

  • Physician buying groups (PBGs)- see Table 1 
    These offer group access to 1 or 2 major vaccine manufacturers. Competing vaccine companies will not be in a PBG together. A major benefit of the PBG model is discounts—the purchaser may receive up-front discounts based on contract or quarterly rebates based on use.    

  • Group purchasing organizations (GPOs)
    These are typically operated by hospital-affiliated purchasing groups. Although pricing models are not as favorable as in PBGs, purchasers are not limited to certain vaccine manufacturers or products.

Vaccine Administration

There may be ways to manage the costs of vaccine administration.

  • Choosing Staff to Immunize
    Each state has its own rules as to who is qualified to administer immunizations and it is important to be familiar with those regulations. RN's and LPN's, MA's, and, in some offices, the physician or mid-level practiti​oner will administer them. That individual will need to evaluate the appropriate written order, carefully draw up the vaccines with sterile technique, document the administration in the paper or electronic health record, and provide the caretaker with the opportunity to record the vaccine in a personal record or identified on billing stat​ement (visit the vaccine administration​  page for more information).  Most practices have found that validation by a second staff person increases quality and billing accuracy.  

    All providers must be properly trained and familiar with the potential side effects from each of the vaccines. Most group practices have found that medical assistants are the most cost effective providers to administer vaccines. Registered nurses are best utilized to sup​​ervise other employees, provide medical triage, and to give medical advice. Generally, the employee who is able to perform the work at the lowest price should. For example, do not use a pediatrician when an RN is just as able to do the work.

    Optimum vaccine administration will be achieved when all necessary immunizations are ordered and discussed by the physician, administ​​ered by an efficient medical assistant, and documented and billed at an appropriate vaccine cost and administrative fee.

  • Maximize Opportunities

    Vaccines should be administered according to the joint guidelines developed by the Advisory Committee on Immunization​​ Practices  (ACIP) and AAP. It is important to note that well visits are the usual occasion to provide appropriate immunizations, but that any office encounter provides an opportunity to update a child's protection. Ordinary sick visits should not be a "missed opportunity" for vaccination. Office staff may check for missing immunizations when making appointments or triaging the patient in the office.​

    A general busine​​​ss principle to follow is that the more one can accomplish at a single visit, and the more one can charge, achieves better compliance with pay for performance and achieves fewer visits that ultimately decrease office overhead.

  • Utilizing combination vaccines with appropriate coding

    Using combination vaccines, and coding the appropriate vaccine administration fee for each component of the vaccine, allows practitio​ners to provide combination vaccines without a financial loss compared to vaccinating with individual doses. Visit the coding page for more information.​

Deciding on a Group:

Below are some questions to ask when deciding whether a specific PBG or GPO is right for you:

  • Which manufacturer(s) are included in the program? Under what circumstances can I purchase outside the plan? What are the purchasing compliance requirements?
    • Based on this contract, how will my usual vaccine regimen be affected? Would I need to start administering different vaccines? How will this affect office education or nurses' time?
    • If I have to change the type of vaccine I order, is the change worth it? Is there another option with similar pricing that would allow me to order what I currently use?
  • Is there a cost to participate? What is the length of my contract commitment? Does this plan provide rebates to its participants?
  • Is pricing tied to volume? Do all participants have the same terms?
    • Does placing large- or small-volume orders allow me to receive the optimal discount?
    • How do your discounts compare with my current pricing?
    • Can I take advantage of additional manufacturer discounts through this program?
    • How frequently am I allowed to order? What is the process to order vaccines? Is a code needed to order online? Is there an administrator to call?
    • Can the practice order whenever it wants? Is there a limit to how many orders can be placed in a given time? What is the process for ordering (e.g., phone, online)?
    • Can I reduce my practice's time and resources spent on ordering vaccines so that maximum discounts are still achieved? Does the program eliminate the need to order strategically to achieve best pricing?
  • What customer-service resources are in place to answer our questions and provide supply assistance? How long has the plan been in business and how many doctors does it work with? (You can also ask your manufacturer representatives for their views of the program.)
  • Are there geographic limitations to participation?
  • What value-added services (eg, payment support, office supplies) does the plan provide?

Physicians have reported working with the following buying groups or group purchasing organizations in the past:

Table 1. Physician Buying Groups and Group Purchasing Organizations


 The Latest on Immunizations

Grou​p​ Name Items included in Group Membership/Fee Requirements Contact Information
AAP Affinity Program - Child Health Advantage Vaccines
Clinical supplies
Business services
AAP Member. Membership Coordinator
Atlantic Health Partners

Office Supplies
Medical Supplies
Patient Recall Program
Discounts for Vaccine Refrigerator/ Freezers

None.​ Jeff Winokur
CASA Physicians Alliance Vaccines
Medical and Surgical Supplies
Office Supplies
Rebate Program
No fees. 
Physicians and physician groups in the United States may participate.​

Andi Dixon or Shari Smith 

CCPA Purchasing Partners Vaccines, Medical Supplies, Computer Hardware, Commercial Tenant Representation, Document Storage/Scanning/Shredding, Electronic Payment Services, Insurance Brokerage, IT Support, Medical Waste Disposal, Office Equipment/Supplies/Furniture, Payroll Services, Temporary Staffing



Administrative Award for Members

Paresh Patel​
Children's National Health Network (CNHN) Vaccines
Office Supplies
Medical Supplies
No fees. Must be a member of CNHN to access contracts, programs, & services. Donnita Pickett
Children's Practicing Pediatricians, Inc Vaccines
Office Supplies
Medical/Surgical Supplies
No fees Children's Practicing Pediatricians, Inc.
Cumberland Pediatric Foundation Vaccines
Medical Supplies
No fees.
May be required to maintain certain benchmarks
Practices must give 30 day notice to opt out of  agreement.
Lora Harnack
Fair Advantage Consortium Vaccines
Medical Supplies
  Robin Riggs
Integrated Physician Solutions (IPS)

Office Supplies
Medical Supplies
Malpractice Insurance

No fees. Lynne Sherman
Kelson Vaccines Unknown. 866-820-4898
Main Street Vaccines

Medical Supplies
Surgical Supplies
Vaccine Refrigerators

No fees.

Allen Menkin, MD, MS, FAAP President

Kate Beggerow, Administrator

Medical Practice Purchasing Group (MPPG)

Office Supplies
Medical Supplies
more Contracts

No fees.​
Loyalty payments for members in good standing.

Brian K. Greenberg, MD, FAAP

Leslie Fuchs

National Physician Care Vaccines 
Medical Supplies 
Office Administrative Services              
Internet and Phone Service
Private practice physicians and clinics. 
No fees for private practice physicians.
Richard Miles
National Discount Vaccine Alliance Vaccines
Office Supplies
Medical Supplies
No fees. Kathleen Cain, MD, FAAP
Northampton Area Pediatrics Vaccines
Office Supplies
Medical Supplies
AAP membership. Cindy Mayo
Pediatric Alliance Vaccines Medical Supplies

No membership fee.Virginia

Dr Richard Grossberg
Richard Lander

Pediatric Federation LLC Vaccines
Office Supplies
Medical Supplies
No fees.

Kathy Chebib
855-733-4233 x81

Peds Pal Vaccines
Office Supplies
Medical Supplies
Physicians' Alliance of America, Inc.

Vaccines Rebate Program
Malpractice Insurance
Office Supplies
Medical Waste Removal 

No membership fees.

Private practices of all sizes and specialties in the United States are eligible. 
Heather McKelton
Primary Care Alliance Vaccines
Medical Supplies
Any physician or physician group in the United States may participate. No fees Amy Dahl

River Valley Pediatricians, Inc. (RVPI)


Office Supplies
Medical Supplies
Annual fee.
Must be community-based physician in the metropolitan area of Cincinnati, OH.
Ed Freeman
Southern California Children's Health Network Vaccines No fees

Robert Kaplan
Angela Deanda

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