Community Pharmacies Play Greater Role in Increasing Flu Immunization Rates

Background

Every year news outlets warn us of the impending flu season and report on locations that are especially hard hit with the latest epidemic. The Centers for Disease Control and Prevention (CDC) estimates that each year 5% to 20% of the U.S. population is affected by the flu and an average 226,000 patients are hospitalized for flu-related complications. Annual estimates of flu-related deaths range from 3,000 to 49,000.¹ Among working adults ages 50-64 years, the flu is responsible for 45% of lost workdays and 49% of low productivity during the flu season.²

What we commonly call “the flu” is influenza, an acute viral disease that affects the respiratory tract. In the U.S., flu season occurs in the fall and winter, with the peak hitting anywhere between late November and the end of March.²

While flu infections for most healthy individuals are uncomplicated – meaning they typically subside within seven days – certain populations can be severely affected. Children, the elderly, people with chronic conditions, pregnant women, and people who may be immunocompromised tend to suffer the worst. These populations are at greater risk for complications that can lead to pneumonia, hospitalization and even death.

The best way to reduce your risk of catching the flu and giving it to others is to get an annual flu vaccine. The flu vaccine helps prevent infection by causing your body to develop antibodies against the virus in the vaccine. The more people vaccinated against the flu, the more difficult it is for the virus to spread through the community.³ One study of nearly 2,700 patients observed a 56% reduced risk of medical visits among vaccinated patients compared to patients not vaccinated during the review period of December 3, 2012, to January 19, 2013.⁴

Role of the community pharmacist

Though most children and adults are encouraged to get a flu vaccine, many of them don’t. Access to the vaccine and out-of-pocket costs are two of the primary hurdles facing patients who want to be immunized. Fortunately, there are ways to help patients overcome these challenges.

Local pharmacists play an important role in increasing immunization rates within their community. Retail pharmacy is becoming one of the fastest growing venues for administering immunizations and improving community immunization rates. Pharmacists are approved to administer vaccines in all 50 states. Nationwide, the number of pharmacists trained to deliver vaccines has nearly quadrupled since 2007, from 40,000 to 150,000 in 2011 (Figure 1).⁵

FIGURE 1

As nearly 93% of the U.S. population lives within five miles of a community retail pharmacy,⁶ receiving a vaccination at a local pharmacy is typically far more convenient than going to a physician office. And unlike a doctor’s office, pharmacists typically don’t require an appointment for a visit. Getting a flu shot at the pharmacy also can save members from paying out of pocket at the physician’s office and then having to submit a receipt for reimbursement. At the pharmacy, the member simply pays their copay. For these reasons, community pharmacies can help alleviate two of the most common challenges people face when getting vaccinated.

The good news is that vaccination rates are increasing steadily year to year (Figure 2)⁷. Flu vaccination coverage among children increased by 5.1 percentage points for the 2012–13 season compared to the 2011–12 season and 12.9 percentage points from the 2009-10 season. Flu vaccination coverage among adults increased by 2.7 percentage points for the 2012-13 season compared to the 2011-12 season and 1.1 percentage points from the 2009-10 season.⁷

FIGURE 2

In addition, people are becoming more aware of the benefits of getting vaccinated at their local pharmacy. The CDC estimates that about 46% of the U.S. population, representing about 140 million people, would get flu shots during the 2014–2015 flu season. Of this population, it’s estimated about 25% of adults and almost 5% of children will get their flu shots at a pharmacy (Figure 3).⁸

FIGURE 3

Given the ways community pharmacies can help improve access and reduce the out-of-pocket expense of getting the flu vaccine, supporting the ability of community pharmacists to provide flu vaccinations is an important way to improve overall vaccination rates.

Vaccinations and Star Ratings

Increasing flu vaccination rates can improve more than just population health. It also can help improve your Part C Star Rating. The 2016 Part C Star Rating Measure C03, Annual Flu Vaccine, measures the percent of sampled Medicare members receiving flu vaccine and accounts for approximately 1.27% of a plan’s overall Star Rating (a weighted score based on Part C and Part D Summary Ratings). As a result, improving this measure can contribute to a higher Quality Bonus Payment.

MedImpact’s Pharmacy Flu Program offers the following benefits:

• Members can get a flu shot at any network retail pharmacy that provides the service
• Coordination with pharmacies to provide worksite immunization clinics
• More than 60,000 participating pharmacies nationwide
• Access to member outreach and awareness programs*, including letter campaigns, outbound messages and website engagement

Contact your Account Executive to enroll or to learn more about MedImpact’s Pharmacy Flu Program.

Ash Yerasi
Vice President, Network Strategy

*Additional fees may apply

Sources:

1. Centers for Disease Control and Prevention (CDC). Seasonal influenza. Questions & answers. Last updated August 14, 2014. Available at: http://www.cdc.gov/flu/about/qa/disease.htm (accessed June 23, 2015).
2. Nichol KL, D'Heilly SJ, Greenberg ME, Ehlinger E: Burden of influenza-like illness and effectiveness of influenza vaccination among working adults aged 50–64 years. Clin Infect Dis 2009, 48:292–298.
3. Centers for Disease Control and Prevention (CDC). Key Facts About Seasonal Flu Vaccine. Last updated October 22, 2014. Available at: http://www.cdc.gov/flu/protect/keyfacts.htm (accessed June 23, 2015).
4. Centers for Disease Control and Prevention (CDC). Interim adjusted estimates of seasonal influenza vaccines effectiveness—United States, February 2013. MMWR Morb Mortal Wkly Rep 2013;62:119-23.)
5. NPR, Pharmacies Inject Convenience Into Flu Shot Market, http://www.npr.org/sections/health-shots/2011/10/10/141153165/pharmacies-inject-convenience-into-flu-shot-market
6. NCPDP Pharmacy File, ArcGIS Census Tract File, NACDS Economics Department.
7. Vaccination Coverage, United States, 2012-13 Influenza Season, CDC, http://www.cdc.gov/flu/fluvaxview/coverage-1213estimates.htm
8. National Early Season Flu Vaccination Coverage, United States, November 2014, www.cdc.gov/flu/fluvaxview/nifs-estimates-nov2014.htm