Learn strategies to manage vaccine purchase costs. While there are many costs associated with purchasing and administering vaccines, there are ways for pediatric offices to manage these costs to cover overhead.
There are multiple ways to order vaccines for your practice. It is vital to understand the pros and cons of each to ensure your practice remains financially viable.
- Standard programs: Direct purchasing access is offered by all major vaccine manufacturers.
Pros: Easy access, prompt pay discounts, online order discounts, and promotional sales.
Cons: Large fluctuations in pricing depending on market competitiveness, lack of discounted pricing due to lower volume being purchased by individual practices.
- Physician buying groups: These offer access to 1 or 2 major vaccine manufacturers. Competing vaccine companies will not be in a physician buying group (PBG) together. (For example, Sanofi and GlaxoSmithKline will not be part of the same group, because they offer similar vaccines).
Pros: Lower cost than purchasing as an individual, due to group pricing discounts; all the "pros" listed for standard programs; potential rebates (depending on the manufacturer with whom the PBG is contracted).
Cons: The limited ability to purchase vaccines from manufacturers that are not part of the PBG contract, the potential for being dismissed from the PBG if terms of membership aren't met or honored.
- Group purchasing organizations: These are typically operated by hospital-affiliated purchasing groups.
Pros: Purchases are not limited to certain vaccine manufacturers or products.
Cons: Pricing models are not as favorable as in PBGs.
There may be ways to manage the costs of vaccine administration.
- Choosing Which Staff Will Administer Immunizations
- Staff who can administer immunizations at the lowest price should perform the work.
- Become familiar with your state’s rules as to who is qualified to administer vaccines, as it varies by state.
- Ensure staff are properly trained on all aspects of vaccine administration. Consider validation by a second staff person, which may increase quality and billing accuracy. All providers must be properly trained and familiar with the potential side effects from each of the vaccines.
- Maximize Opportunities
- Don’t miss the opportunity to vaccinate at sick visits, when appropriate.
- Assign office staff to check for missing immunizations when making appointments or triaging the patient in the office.
- The more your practice can accomplish at a single visit, the more financial benefits to your practice; as this will facilitate achievement of pay for performance targets and free up appointments for other patient visits.
- Utilizing combination vaccines with appropriate coding
Use combination vaccines, and code the appropriate vaccine administration fee for each component of the vaccine. This allows your office 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 physician buying group (PBG) or group purchasing organization (GPO) is right for you:
- Which manufacturer(s) are included in the program? Under what circumstances can I purchase outside the plan (eg, if one manufacturer has a recall or shortage)? What are the purchasing compliance requirements?
- On the basis of this contract, how will our usual vaccine routine be affected? Will we need to administer different vaccines (eg, Pediarix vs Pentacel)? How will this affect office education or nurses' time?
- If we have to change our routine, will the change be worth it? Will another option with similar pricing allow us to continue ordering what we currently use?
- Is there a cost to participate? What is the length of the contract commitment? Does this plan provide rebates to its participants?
- Is pricing tied to volume? Do all participants in the purchasing group have the same terms?
- How do these discounts compare with our pricing?
- Does placing large- or small-volume orders allow us to receive the optimal discount?
- How frequently are we permitted to order? What is the process to order vaccines (online, calling)? Is a code needed to order online? Is there an administrator to call for the purchasing group? Is pricing tied to volume?
- Do all participants in the purchasing group have the same terms?
- Will additional manufacturer discounts apply through this program (eg, promotions, prompt pay discounts)?
- Will we reduce our practice's time and resources, spent on ordering vaccines, so maximum discounts will still be achieved? Will 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 assistance? How long has the purchasing group been in business? How many physicians does the purchasing group represent? (You can also ask your manufacturer representative, if you have one, for their views of the purchasing group.)
- Are there geographic limitations to participation?
- What value-added services (eg, payment support) does the purchasing group provide?
Buying Groups and Group Purchasing Organizations
Physicians have reported working with the following buying groups or group purchasing organizations in the past. Download the PDF version to view information about these groups at a glance.
American Academy of Pediatrics