Do Doctors Get Rich Off Vaccines?

Jess Steier, Elana Pearl Ben-Joseph, Jen Covich Bordenick, and David Higgins: 

Recently, the Texas attorney general launched a formal investigation into what he called “unlawful financial incentives” for childhood vaccines, saying that he would “ensure that Big Pharma and Big Insurance don’t bribe medical providers to pressure parents to jab their kids.”

The timing was uncanny. The four of us had just completed a six-month investigation into this exact question: Do pediatricians get rich from vaccines? 

Our answer, after analyzing available commercial reimbursement data from four major insurers across all 50 states, reviewing state Medicaid fee schedules, and interviewing pediatricians about the financial realities of vaccine delivery: no. . . .

The economics vary dramatically depending on where you practice and who you serve. In Colorado, commercial insurers pay a median of $42 for vaccine administration; Medicaid pays $21. In Mississippi, commercial rates hover around $22, while Medicaid pays just $11.68, well below what it actually costs to store and administer a vaccine.

That's why many doctors have stopped giving vaccines to adults; because it costs so much to store and administer vaccines that they lose money. Like most Americans I get all my vaccines at the pharmacy, because the volume of shots they give greatly reduces their storage costs, and they have lower overhead than physicians' offices.

The big numbers being thrown around about payments for giving vaccines relate to insurance company "quality programs," some of which do indeed pay doctors for giving vaccines. That's because they reward doctors for doing things that limit future costs to insurers, and giving people vaccines has enormous payoff in terms of reducing future hospitalizations etc. But those are broad programs that pay related to all sorts of metrics, of which giving vaccines is only one. And, remember, insurance companies do this because these programs reduce their costs in the long run.

Another point about the bogus numbers is that the people spreading them seem to think that the whole amount paid to the practice is income to the doctor, which is of course not true; again, many doctors actually lost money giving childhood vaccines, especially with Medicaid patients.