{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:06:28Z","timestamp":1760241988901,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T00:00:00Z","timestamp":1542758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merck and Co., Inc","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Herpes zoster (HZ) vaccination is approved for adults aged 50+ for the prevention of HZ, but it is underutilized. The objective of this study was to evaluate the association between out-of-pocket cost and HZ vaccine utilization. Adults aged 65 or older enrolled for at least 12 months in Medicare Advantage\/Part D (MAPD) and Medicare Part D only (PDP) plans from 1 January 2007 to 30 June 2014 were selected. Abandonment was defined as a reversed claim for HZ vaccine with no other paid claim within 90 days. Out-of-pocket costs used were actual amounts recorded in the claim. Overall, the HZ vaccine abandonment rate was 7.3%. Mean out-of-pocket costs were higher for individuals who abandoned versus those who did not ($88 (\u00b1$55) versus $80 (\u00b1 $49)). Logistic regression indicated individuals with out-of-pocket costs of $80\u2013$90 were 21% more likely (OR = 1.21, 1.16\u20131.27 95% CI), and those with out-of-pocket costs &gt;$90 were 90% more likely (OR = 1.90, 1.85\u20131.96 95% CI) to abandon than those with out-of-pocket costs &lt;$80. The models also suggested that socioeconomic, racial, and ethnic disparities in vaccine abandonment existed. Different vaccine targeting efforts and pharmacy benefit design strategies may be needed to increase use, improve adherence, and minimize disparities.<\/jats:p>","DOI":"10.3390\/vaccines6040078","type":"journal-article","created":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T03:41:31Z","timestamp":1542944491000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Out-of-Pocket Cost on Herpes Zoster Vaccine Uptake: An Observational Study in a Medicare Managed Care Population"],"prefix":"10.3390","volume":"6","author":[{"given":"Zhuliang","family":"Tao","sequence":"first","affiliation":[{"name":"Comprehensive Health Insights, Inc., a Humana Co., 515 West Market Street Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Li","sequence":"additional","affiliation":[{"name":"Comprehensive Health Insights, Inc., a Humana Co., 515 West Market Street Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Stemkowski","sequence":"additional","affiliation":[{"name":"Comprehensive Health Insights, Inc., a Humana Co., 515 West Market Street Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly D.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Merck and Co., Inc. Center for Observational &amp; Real World Evidence, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo J.","family":"Acosta","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongmu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Merck and Co., Inc. Center for Observational &amp; Real World Evidence, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Mark","family":"Fendrick","sequence":"additional","affiliation":[{"name":"Center for Value-Based Insurance Design, North Campus Research Complex, 2800 Plymouth Road, Building 16\/Floor 4\/Room 455S, Ann Arbor, MI 48109-2800, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1001\/jama.1957.02980030041010","article-title":"The natural history of herpes zoster","volume":"164","author":"Burgoon","year":"1957","journal-title":"J. Am. Med. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1136\/bjo.71.5.353","article-title":"Natural history of herpes zoster ophthalmicus: Predictors of postherpetic neuralgia and ocular involvement","volume":"71","author":"Harding","year":"1987","journal-title":"Br. J. 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