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Reimbursement Woes Loom Over HPV Vaccinations


 

NEW ORLEANS — Getting reimbursed is the top concern for physicians who offer the human papillomavirus vaccine, according to a survey by researchers at Brigham and Women's Hospital, Boston.

Using a Web-based tool, Brigham resident Dr. Emily M. Ko and colleagues surveyed 1,488 physicians who practiced with the Partners HealthCare System from May to July 2007. Overall, 424 physicians participated, of whom 87 (21%) were ob.gyns., 196 (46%) were internists, and 104 (25%) were pediatricians, said Dr. Ko in a poster at the annual meeting of the American College of Obstetricians and Gynecologists.

Of those who participated, 80% said they offer the HPV vaccine. That included 92% of pediatricians, 81% of ob.gyns., and 78% of internists. Male physicians were 54% less likely to provide the vaccine than were female physicians. The survey did not ask questions that would determine why some might be less likely to offer the vaccine, Dr. Ko said in an interview.

Physicians in community hospitals were twice as likely to offer the vaccine as were those at tertiary care facilities. Primary care physicians were 14 times more likely than specialists to offer it. Overall, the respondents cited reimbursement as the main hurdle to offering the vaccine. Most (95%) physicians said it would not promote promiscuity or decrease condom use, 3% were neutral, and 1.4% said it might promote promiscuity. There was no difference between genders or in specialties on the promiscuity issue, though 7% of physicians said parents might fear vaccination would promote promiscuity, and 19% of pediatricians said parental fear was a barrier.

Dr. Ko reported no conflicts of interest.

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