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Understanding Coverage Considerations for COVID-19 Vaccines and Treatments

Publication Date
Aug 31, 2022
Authors
Trinidad Beleche, Laina Bush, Kenneth Finegold, Teresa Manocchio, Sarada Pyda, Lok Wong Samson, Benjamin D. Sommers

COVID-19 vaccines and treatments have been an important tool in the prevention of COVID-19, including preventing hospitalizations and deaths. After the public health emergency (PHE) for COVID-19 ends, COVID-19 vaccines and treatments will need to transition from direct government purchase under Emergency Use Authorizations (EUAs) to established regulatory pathways for FDA coverage and payment by public and private payers. In preparation for this process, which we refer to as "commercialization", this report: 1) provides an overview of the current coverage and payment of COVID-19 vaccines and treatments across payers; 2) identifies expected gaps in coverage after the end of U.S. Government-provided supply and key considerations for coverage determinations post-PHE; and 3) presents estimates on expected savings and spending offsets for a select set of COVID-19 products that have been demonstrated to reduce COVID-19-related hospitalizations. The report concludes with potential next steps for payers as they navigate the coverage and payment process to prevent gaps in availability of lifesaving COVID-19 vaccines and treatments.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Teresa Manocchio, (202) 604-5913, Teresa.Manocchio@hhs.gov. Content will be updated pending the outcome of the Section 508 review.

Product Type
Report
Populations
Uninsured & Underinsured
Program
Children's Health Insurance Program (CHIP) | Health Insurance Marketplace | Medicaid | Medicare