Vaccine Coverage, Pricing, and Reimbursement in the U.S.

a. The agreement between the federal government and AstraZeneca states that “at least 300 million doses will be made available” to the government with up to $1.2 billion in government support.
b. Sanofi/GlaxoSmithKline and Merck/IAVI vaccine trials are testing 1 and 2 dose regimens.

Table 2: Overview of How Vaccine Prices Are Set
Program or Type of Coverage Summary of how vaccines prices are set
Medicare For the influenza and pneumococcal vaccines covered under Medicare Part B, reimbursement is set at 95% of average wholesale price. For vaccines covered by Medicare Part D, private Part D plans and pharmacy benefit managers can negotiate with manufacturers to get rebates and other price concessions to lower the net price of vaccines.
Private Insurance Health insurers and pharmacy benefit managers can try to negotiate with manufacturers to get rebates and other price concessions to lower the net price of vaccines.
Vaccines for Children The Secretary of HHS negotiates the price of vaccines and purchases doses that are then distributed across the country.
Medicaid States set provider reimbursement for vaccines. Vaccines are not eligible for Medicaid rebates.
Section 317 CDC negotiates the price of vaccines and purchases doses that are then distributed across the country.
VA As with other prescription drugs, the VA receives a minimum discount that is set by law. The VA is allowed to try to negotiate deeper discounts with manufacturers.
Table 3: Vaccine Costs Across Key Federal Programs
Vaccine Brand Name List Price / Dose CDC Adult Vaccine Price VFC Price VA Cost/ Dose Medicare Cost/ Dose
Hib ActHIB® $17 N/A $10 $7 $35**
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Adacel® $47 $25 $33 $25 $57**
Influenza (Age 6 months and older) Afluria® Quadrivalent $17 $12 $12 $12* $10-$21
MENB – Meningococcal Group B Bexsero® $179 $107 $120 $107 $189**
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Boostrix® $42 $25 $33 $25 $60**
DTaP Daptacel® $32 N/A $19 $15 $63**
Hepatitis B Adult Engerix B® $62 $26 N/A $37 $70
Hepatitis B (Pediatric) Engerix B® $25 N/A $15 $13 $28
Influenza (Age 6 months and older) Fluarix® Quadrivalent $17 $12 $14 $13 $20
Influenza (Age 4 years and older) Flucelvax® Quadrivalent $24 $14 $15 $14* $28
Influenza (Age 6 months and older) FluLaval Quadrivalent $17 $12 $14 $13 $20
Influenza Live, Intranasal (Age 2-49 years) FluMist® Quadrivalent $24 $16 $19 $17* $27
Influenza (Age 6 months and older) Fluzone® Quadrivalent $17 $13 $14 $13 $10-$21
HPV-Human Papillomavirus 9 Valent Gardasil®9 $228 $141 $187 $141 $241**
Hepatitis A Adult Havrix® $72 $33 N/A $36 $84**
Hepatitis A (Pediatric) Havrix® $34 N/A $21 $20 N/A
Hepatitis B Adult Heplisav-B™ $121 $73 N/A $78 $131
Hib Hiberix® $11 N/A $9 $8 $18**
DTaP Infanrix® $25 N/A $19 $15 $45**
e-IPV IPOL® $35 N/A $14 $19 $56**
DTaP-IPV Kinrix® $54 N/A $42 $29 $78**
Meningococcal Conjugate (Groups A, C, Y and W-135) Menactra® $128 $75 $96 $76 $144**
Meningococcal Conjugate (Groups A, C, Y and W-135) Menveo® $135 $70 $96 $70 $131**
Measles, Mumps, & Rubella M-M-R®II $79 $49 $22 $49 $90**
DTaP-Hep B-IPV Pediarix® $83 N/A $61 $46 $103**
Hib PedvaxHIB® $26 N/A $14 $19 $49**
DTaP-IP-HI Pentacel® $100 N/A $62 $46 $100**
Pneumococcal Polysaccharide (23 Valent) Pneumovax®23 $105 $63 $59 $63 $120
Pneumococcal 13-valent Prevnar 13™ $202 $132 $144 $132 $230
MMR/Varicella [2] ProQuad® $225 N/A $138 $137 $224**
DTaP-IPV Quadracel™ $55 N/A $42 $29 N/A
Hepatitis B Adult Recombivax HB® $61 $25 N/A $26 $70
Hepatitis B (Pediatric) Recombivax HB® $24 N/A $13 $9 $28
Rotavirus, Live, Oral, Oral Rotarix® $125 N/A $98 $70 N/A
Rotavirus, Live, Oral, Pentavalent RotaTeq® $85 N/A $72 $55 N/A
Zoster Vaccine Recombinant, Adjuvanted Shingrix® $151 $102 N/A $102 $161**
Tetanus and Diphtheria Toxoids TDVAX™ $26 $16 $16 $16* $39**
Tetanus and Diphtheria Toxoids Tenivac® $35 N/A $21 $16 $50**
MENB – Meningococcal Group B Trumenba® $150 $93 $114 $94 $167**
Hepatitis A-Hepatitis B Adult Twinrix® $109 $62 $63 $62 $120**
Hepatitis A Adult Vaqta® $70 $33 N/A $36 $89**
Hepatitis A (Pediatric) Vaqta® $33 N/A $21 $18 N/A
Varicella Varivax® $136 $82 $109 $82 $142**
NOTES: VFC is Vaccines for Children.
* is the listed price for the Federal Supply Schedule because no VA/Big Four price was listed.
** is the listed price for drugs covered under Medicare Part D and does not account for rebates.
The Part B prices for Engerix-B, Recombivax HB, and Prevnar 13 are listed because that vaccine is typically covered under Medicare B; although a relatively small number of beneficiaries do receive the vaccine through Part D because they do not meet the Part B coverage criteria.
In general, Medicare vaccine pricing data does not distinguish between adult and pediatric versions of a vaccine.
The list price per dose is the wholesale acquisition cost and sometimes also includes the federal excise tax, which is between $0.75 and $2.25. That price is taken from the CDC’s price list and is listed there as the “Private Sector Cost/ Dose.”
For simplicity, in cases where two different versions of the same vaccine have prices that vary by $2 or less, we only display the lower price. These different prices are typically for different types of packaging for the same vaccine (for example: syringe vs vial).
SOURCE: Medicare cost for vaccines covered through Medicare Part B are taken from the 2020 ASP file and Seasonal Influenza Vaccines Pricing List; Part D prices come from the 2018 Part D spending dashboard.
CDC adult vaccine price and VFC price come from the CDC Vaccine Price List https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html.
The list prices come from the CDC Vaccine Price List and are the “Private Sector Cost/Dose” https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html.
The VA/Big Four and federal supply schedule prices are taken from the VA’s Office of Procurement, Acquisition and Logistics and are available here: https://www.va.gov/opal/nac/fss/pharmPrices.asp.

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