RE: Vaccine ?s

[Guest guest]

Chrissie and ,

I have the misfortune of not having any pharmacies that will

order vaccines so must get them for the patient myself.  I will only order the

really expensive vaccines if requested like Zostavax and Gardisil.  I buy

things like MMR from other doctors as I have no need for 10 of them.  I buy

Menactra, Adacel, Td, Pneumovax and Influenza for myself, as well as Hep B and

Hep A.  I had to buy 10 doses of pediatric Hep A which is unfortunate as not

much need but adult Hep A can be on a dose by dose basis.

Although the VFC program is to supply vaccines for all “uninsured”

children (even those with insurance that doesn’t cover routine

vaccination), I don’t participate as not a strong need and a lot of

paperwork and waste.  I tried to send some adolescents to the public health

clinic only to find out they charge full price for vaccine and for some reason

are not getting them through the VFC program.  I am still at a loss about what

to do about this as I don’t want to take on the extra burden of the VFC

myself.

Medicare Zostavax I am having them pay for before I order.

Word of note, Medicare Part B will no longer be paying the

administration for Zostavax (G0034? Or something like that) and that will now

be “billed” to Part D too, adding to the confusion.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Haresch

Sent: Wednesday, January 02, 2008 10:10 AM

To:

Subject: Re: MacFriendly EMRs, Vaccine ?s

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?