With Covid-19 vaccines expected to enter the commercial market early next year, costs are also likely to rise substantially—potentially making it more difficult for those at highest risk, including the uninsured, to access vaccines going forward.

Covid-19 vaccine prices will likely rise on the commercial market

According to a new report from the Kaiser Family Foundation (KFF), the U.S. government has spent over $30 billion on developing and purchasing Covid-19 vaccines so far. However, funding for Covid-19 vaccines and therapeutics has dwindled, and the government can no longer afford to purchase vaccines and make them available for free to the public.

The Biden administration last month requested an additional $10 billion from Congress for its Covid-19 response, including $2.5 billion to ensure continued access to vaccines and therapeutics, but the request is unlikely to be approved.

As of now, Covid-19 vaccines are likely to transition to the commercial market as soon as the first quarter of 2023. With this transition, the costs of the vaccines are likely to increase significantly from what the federal government has paid for them so far.

To date, the federal government has purchased 1.2 billion doses of the Pfizer-BioNTech and Moderna Covid-19 vaccines for $25.3 billion, at a weighted average of $20.69 per dose. Pfizer-BioNTech's vaccine has cost between $19.50 and $30.48 per dose, with the highest price being for its new bivalent booster. For Moderna, its vaccine has cost between $15.25 and $26.36, with the highest price also for its new booster.

Currently, commercial prices for the Covid-19 vaccines have not been released, but both Pfizer and Moderna have suggested that price ranges will be three to four times higher than the federal prices. So far, Pfizer has indicated that a commercial price per dose could be between $110 and $130, while Moderna has suggested a cost between $82 and $100 per dose.

According to KFF, commercial Covid-19 booster shots could cost between $6.2 billion and $29.7 billion annually, depending on their price per dose and how many people choose to get vaccinated.

How will higher vaccine costs affect patients?

After Covid-19 vaccines enter the commercial market, most people with health insurance will likely be able to get them, including boosters, for free, even after federal supplies run out. However, the costs of the vaccines, including for administration, will be shifted to public and private insurers.

Among private insurers, the increased costs of Covid-19 vaccines could also lead to higher health care premiums. In a recent analysis of 2023 premium filings from ACA Marketplace insurers, some insurers said the end of federal vaccine purchasing "could have a small upward effect on premiums" in the coming years, KFF writes.

For people who are uninsured or underinsured, the increased costs could deter them from vaccination. Compared to the commercial price for the annual flu vaccine ($18 to 28 per dose), the suggested commercial cost for the Covid-19 vaccines ($96 to $115 per dose) is much higher.

"The roughly 8% of the US population that has no health insurance will be worst hit" by Covid-19 vaccines entering the commercial market, according to Sam Fazeli from Bloomberg Intelligence. Uninsured individuals have a higher risk of infection because they typically work in jobs that regularly expose them to the virus. They also have higher rates of obesity and other health issues, which make them more susceptible to severe infections.

To ensure guaranteed access to vaccines for uninsured adults, the Biden administration has proposed a potential "Vaccines for Adults" program that would cost $25 billion over 10 years. Through the program, uninsured adults would be able to receive all vaccines recommended by CDC's Advisory Committee on Immunization Practices, including Covid-19 vaccines, free of charge.

However, it is not clear whether such a proposal would pass in Congress, KFF writes, so access to vaccines for the uninsured is likely to remain an issue going forward.

Overall, "the price for future doses is hard to know, and they could be higher than those implied by companies so far if new formulations are developed, or could come down if discounts are negotiated," KFF writes. "… Without advanced purchases or guarantees by the federal government, it's also possible that future supply may not always match demand, which would have unpredictable consequences for the price and availability of vaccines in the U.S." (Kates et al., Kaiser Family Foundation, 12/7; Luhby, CNN, 12/7)