Flu Season is Approaching

Emily Torgerson  •   July 18, 2019

Did You Know?

During the 2017-2018 flu season, the flu was responsible for:

49 million flu illnesses

23 million flu-related medical visits

960,000 hospitalizations

80,000 flu-related deaths

However, the flu vaccine prevented an additional:

7 million flu illnesses

8,000 flu-related deaths

109,000 hospitalizations1

US Vaccination Rates Need Improvement

While vaccines are becoming increasingly accessible, vaccination rates are still far from desirable and well below government goals. According to a National Opinion Research Center poll from 2018, 41 percent of adults did not intend to receive their flu shot, the main reason being concern about possible side effects.2 It’s not only important to protect yourself from the virus but also people around you. A Centers for Disease Control and Prevention study estimates employees lose out on approximately $6.2 billion per year in wages due to lost productivity from illness.3

Time to Act

We know, we know. It’s still summer! Why are we talking about the flu already?

The flu season may vary geographically but is usually considered to run from August/September through March/April, with a seasonal peak around February — which means it’s right around the corner!

Coverage mandates are required under the Affordable Care Act for many vaccines, including the flu, but the way coverage is handled is at the plan’s discretion. A plan may cover under the medical benefit alone or under both the medical and pharmacy benefit. Many people receive their flu vaccine from their local pharmacist, while others may need to rely on their doctor’s office for their shot. Some employers even bring someone into the workplace to administer the flu vaccine to their employees.

Cover Your Participants Under Your Pharmacy Benefits Plan

Some plans still don’t cover immunizations under the pharmacy benefit, which is unfortunate as pharmacists are one of the most accessible and convenient health care professionals.  Coverage under the pharmacy benefit can be added very easily and tends to be more cost-effective than the medical benefit. Pharmacies that are unable to process immunizations under a pharmacy benefit may still engage in immunization services but may have to bill the plan participant’s medical benefit or request payment up front and inform the individual to seek reimbursement from their medical provider. This provides extra hassle to plan participants and may result in higher costs to them as well as plan sponsors.

The flu causes millions of illnesses, hundreds of thousands of hospitalizations and thousands of deaths every season. By being proactive, you can help keep both your workforce and your bottom line healthy. Help your participants get vaccinated by ensuring they have easy and cost-effective access.  If you want to implement CVS Caremark’s Broader Vaccination Network, contact your National CooperativeRx account executive today!

 

  1. https://www.cdc.gov/flu/about/burden/2017-2018.htm
  2. https://www.usnews.com/news/health-news/articles/2018-12-06/survey-43-percent-of-adults-will-not-get-flu-shot
  3. https://www.businessinsider.com/2018-flu-season-will-cost-employers-billions-2018-1