Drug News

The Hidden Price Of RSV Vaccine

According to an article published on August 25th in The New York Times, certain health insurance providers are not covering the newly approved vaccines for respiratory syncytial virus (RSV), resulting in older adults having to pay $330 from their own pockets.

Following a challenging viral season last year, during which RSV, COVID-19, and the flu simultaneously strained hospital capacities, the Food and Drug Administration (FDA) has given its approval to four RSV vaccines. These include two vaccines designed for adults aged 60 and above, one for toddlers, and another for pregnant individuals, which offer protection to newborns.

The Centers for Disease Control and Prevention (CDC) report an annual death toll of between 6,100 and 10,300 individuals due to RSV contraction. The recent approvals brought a glimmer of hope for reducing this burden; however, the accessibility of these vaccines could be hindered by insurance company practices.

While Medicare Part D includes coverage for the RSV vaccine, Medicare Part B does not extend the same coverage, as detailed by The New York Times. Furthermore, several private payers have chosen not to cover the cost of the vaccine, including Anthem Blue Cross Blue Shield. The result of this lack of coverage is evident in the experiences of older adults who, due to the financial burden, had to forego receiving the vaccine even after attending pharmacy appointments.

The introduction of new RSV vaccines has the potential to alleviate the severe health risks posed by the virus, but the financial barriers created by insurance coverage gaps are leaving a significant portion of older adults without access to the protection these vaccines offer.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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