Private Payers News

CareFirst Announces COVID-19 Vaccine Coverage for All Members

Shortly after the FDA approved its first emergency use authorization for a coronavirus vaccine, the payer stated it would offer coronavirus vaccine coverage.

vaccines & immunizations, FDA, CDC, coronavirus

Source: Getty Images

By Kelsey Waddill

- CareFirst BlueCross BlueShield (CareFirst) has announced that it would offer coronavirus vaccine coverage for all coronavirus vaccines for members, including self-insured members.

“The health and well-being of our members and communities remain top priorities for CareFirst,” said Brian D. Pieninck, president and chief executive officer of CareFirst.

“We are fully committed to removing any and all barriers so that people get the care they need. No one should worry about receiving the COVID-19 vaccination because of the cost. This pandemic has proven that we’re better together when we are all healthier, and this includes staying up to date on all recommended and available vaccinations. CareFirst will continue to support our members, communities, providers and public health authorities in the distribution of vaccines and the critically important communications and planning in the weeks and months ahead.”

The reaction to the vaccine has been mixed. In hard hit Boston, the first shipment of coronavirus vaccines to arrive at Boston Medical Center was welcomed by masked, dancing healthcare workers.

However, certain populations of Americans have expressed reticence to receive the vaccine. Almost half of Black survey respondents (49 percent) said that they would not take the vaccine, even if it was backed by scientists and offered to them for free, according to a Kaiser Family Foundation study.

In response, CareFirst committed to working with leaders at the state and local level to disseminate accurate information about the vaccine and about its distribution. The CDC has already released recommended phases for vaccine distribution, the press release reminded.

“We must all work together and follow the vaccine recommendations of health professionals to help stop the spread of COVID-19,“ said Daniel J. Winn, MD, vice president and chief medical officer at CareFirst.

“Protecting our community is a shared responsibility and in order to achieve the most effective health benefits from these vaccines, we must all do our part. Higher percentages of people vaccinated will be important to provide the protection needed to help end this pandemic and help keep ourselves and our communities healthy.”

The announcement came as the US Food and Drug Administration (FDA) issued its first emergency use authorization for a coronavirus vaccine.

On December 11, the FDA granted an emergency use authorization to a coronavirus vaccine developed by Pfizer-BioNTech.

“The FDA’s authorization for emergency use of the first COVID-19 vaccine is a significant milestone in battling this devastating pandemic that has affected so many families in the United States and around the world,” FDA Commissioner Stephen M. Hahn, MD, said at the time.

Most payers are not concerned about covering the vaccine.

Even before the vaccine’s cost had been fixed, payers expressed that they were ready to start reimbursing. Fifty percent of payer survey respondents stated that they were prepared to reimburse vaccines within two months of the FDA approval and 78 percent of the respondents said they could reimburse within four months of FDA approval.

In contrast, payers were more concerned about the drugs’ efficacy. For 47.5 percent of payer respondents, the vaccine’s clinical effectiveness was their primary concern.

Initially, data on Pfizer-BioNTech’s vaccine demonstrated that it was 90 percent effective for patients who had exhibited no signs of coronavirus previous to receiving the drug.

A more recent study, however, indicated that the Pfizer-BioNTech vaccine is actually 95 percent effective.

“We are grateful that the first global trial to reach the final efficacy analysis mark indicates that a high rate of protection against COVID-19 can be achieved very fast after the first 30 µg dose, underscoring the power of BNT162 in providing early protection,” Ugur Sahin, MD, chief executive officer and co-founder of BioNTech, said at the time.

Moderna’s vaccine is a runner-up with comparable effectiveness at around 94.5 percent efficacy.