title: Pharmacy management of vaccines.
abstract: BACKGROUND
  Although standard vaccines have traditionally been granted full coverage in managed care, the recent introduction of several novel vaccine products has necessitated the revision of pharmacy management strategies throughout the nation.
  
  
  OBJECTIVE
  To review pharmacy management strategies for a number of emerging vaccines, with unique plan perspectives from SelectHealth, an Intermountain Healthcare company serving approximately 500,000 members in Utah.
  
  
  CONCLUSIONS
  Because several recently introduced vaccines target previously unaddressed diseases and carry higher costs than traditional vaccines, several plans have adapted a novel approach to manage vaccine coverage on an individual product basis. At SelectHealth, recently introduced vaccines for rotavirus, respiratory syncytial virus (RSV), herpes zoster, and human papillomavirus (HPV) have required special attention in terms of pharmacy management. After carefully weighing acquisition and administration costs, anticipated uptake and use, direct and indirect health care costs averted, and quality of life issues, plan leadership decided to cover many of the new vaccines (i.e., rotavirus, RSV, and herpes zoster) under a nonstandard vaccination benefit. However, because substantial cost savings and high use of the quadrivalent HPV vaccine was anticipated within SelectHealth, the plan decided to fully cover the product.
  
  
  CONCLUSIONS
  Although they complicate traditional pharmacy management, novel vaccines provide clinical benefit that managed care organizations cannot ignore. One universal strategy will not suffice in managing all the different vaccines entering the market, and a tailored approach should be employed based on the individual characteristics and use of each product.
authors.affiliation: SelectHealth, Intermountain Healthcare, Salt Lake City, Utah 84130, USA. Eric.Cannon@selecthealth.org
authors.forename: H Eric
authors.initials: HE
authors.lastname: Cannon
mesh_terms: D003362:Cost-Benefit Analysis; D053061:Herpes Zoster Vaccine / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D019458:Insurance Coverage; D007356:Insurance, Pharmaceutical Services; D008329:Managed Care Programs; D053918:Papillomavirus Vaccines / Q000191:economics / Q000627:therapeutic use; D010593:Pharmaceutical Services; D022261:Respiratory Syncytial Virus Vaccines / Q000191:economics / Q000627:therapeutic use; D022243:Rotavirus Vaccines / Q000191:economics / Q000627:therapeutic use; D014612:Vaccines / Q000191:economics / Q000627:therapeutic use*
chemical_list: D053061:Herpes Zoster Vaccine; D053918:Papillomavirus Vaccines; D022261:Respiratory Syncytial Virus Vaccines; D022243:Rotavirus Vaccines; D014612:Vaccines