Cost of COVID-19 vaccines could skyrocket in commercial environment

Dec. 7, 2022
According to a release from the Kaiser Family Foundation (KFF), If the federal government runs out of money to purchase COVID-19 vaccines, the per-dose price likely would skyrocket and could increase spending on vaccines by billions of dollars a year, a new KFF analysis finds.

To date, the federal government has spent more than $30 billion on COVID-19 vaccines to encourage their development, guarantee a market, and ensure that the public can access them at no charge. The Biden administration has said it can no longer afford to purchase additional doses if Congress does not provide more funds, shifting the burden to the commercial market.

Vaccine makers Pfizer and Moderna have announced that the anticipated commercial price per dose of their vaccines would likely be between $82 and $130 per dose – roughly three to four times what the federal government has paid, according to the KFF analysis.

If payers end up paying those prices for one dose per adult, the analysis estimates that the total cost of purchasing booster shots commercially would run between $6.2 billion and $29.7 billion a year, depending on price and how many people nationally get the vaccine or booster.

Put another way, the federal government could purchase enough bivalent booster shots to serve all adults nationally at its current per-dose price for $7.5 billion, about what it would cost to purchase doses for just a quarter of adults at the higher commercial per-dose price.

While it is possible insurers and other payers could negotiate discounts from the prices suggested by the manufacturers, they will have limited leverage because they will generally be required to cover all recommended vaccines and boosters.

Even after vaccines are purchased commercially, most people with health insurance should still be able to access COVID-19 vaccines without any cost-sharing, and the higher per-dose price would be borne by public and private insurers, including Medicare and Medicaid. For private insurers and their enrollees, these costs could push premiums upward.

People who are uninsured would lose guaranteed access to free COVID-19 vaccines, and the high cost of getting one at the commercial price could discourage some from getting them.

KFF release

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