Addressing Unfunded Vaccines Through a Co-payment Mechanism in Pharmacies

Summary

The goal of this pilot demonstration and evaluation project is to determine the acceptability and feasibility of a co-payment model among the public and providers and assess whether a co-payment model in community pharmacies in Nova Scotia and Ontario increases the accessibility and uptake of recommended but unfunded vaccines. The research questions that guided the development of this study are:

* What is the feasibility of implementing a co-payment model for recommended but unfunded vaccines in community pharmacies?
* To what extent is a co-payment model for recommended but unfunded vaccines perceived as acceptable to community pharmacists and the public?

A co-payment model will be piloted at a maximum of 8 select community pharmacy sites in Nova Scotia (n=4 sites) and Ontario (n=4 sites). Each community pharmacy site will be randomly assigned to pilot one of the steps of the co-payment model for the duration of the demonstration project. At the end of the pilot study, participating pharmacy providers will be asked to complete an online survey about their experiences in implementing the co-payment model into their pharmacy. As part of the co-payment model, recruited members of the public (participants) will choose to receive the vaccine (if eligible) at a reduced cost either for themselves or their dependent (e.g., incapable minor or adult), as part of routine care (following standard pharmacy practice). After receiving the vaccine, the participant will complete an online survey exploring their thoughts on the co-payment model, their satisfaction with the co-payment model, their perception on vaccines in general, and their demographics (such as gender, age, education, race/ethnicity).

Conditions

• Preventable Disease, Vaccine

Interventions

OTHER

Co-payment Model - Step 1

Step 1 of the co-payment model: A pharmacy site from Nova Scotia and Ontario will be randomly assigned to this step where the study will cover the administration service fee (approximately $35.00) and the participant will pay 100% of the vaccine cost out-of-pocket for the eligible vaccine. The vaccines will include FluMist Quadrivalent, Shingrix, and Abrysvo or Arexvy.

OTHER

Co-payment Model - Step 2

Step 2 of the co-payment model: A pharmacy site from Nova Scotia and Ontario will be randomly assigned to this step where the study will cover 50% of the vaccine cost plus the administration service fee and the participant will pay 50% of the vaccine cost out-of-pocket. The vaccines will include FluMist Quadrivalent, Shingrix, Abrysvo or Arexvy.

OTHER

Co-payment Model - Step 3

Step 3 of the co-payment model: A pharmacy site from Nova Scotia and Ontario will be randomly assigned to this step where the study will cover 75% of the vaccine cost plus the administration service fee and the participant will pay 25% of the vaccine cost out-of-pocket. The vaccines will include FluMist Quadrivalent, Shingrix, and Abrysvo or Arexvy.

OTHER

Co-payment Model - Step 4

Step 4 of the co-payment model: A pharmacy site from Nova Scotia and Ontario will be randomly assigned to this step where the study will cover 100% of the vaccine cost plus the administration service fee and the participant will pay 0% of the vaccine cost. The vaccines will include FluMist Quadrivalent, Shingrix, and Abrysvo or Arexvy.

Sponsors & Collaborators

• Dalhousie University

  collaborator OTHER

• AstraZeneca

  collaborator INDUSTRY

• GlaxoSmithKline

  collaborator INDUSTRY

• Canadian Center for Vaccinology

  collaborator OTHER

• Canadian Immunization Research Network

  lead NETWORK

Principal Investigators

• Emily Black, PharmD · Dalhousie University

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

2 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-10-23

Primary Completion

2026-12-31

Completion

2026-12-31

Countries

• Canada

Study Locations