I started this exercise a while back to help my clients who are being courted by different "vaccine delivery vendors," each of which want to convince you to outsource your vaccine business to them.  Essentially, the model is that they purchase your vaccines and collect the money you are paid for them and, in return, you don't have to worry about the risk and effort to manage your inventory (in theory).  Let me be clear: my clients overwhelming regret working with these vendors.  Although I do think they offer real value in some spaces (DPC practices, startups with no capital, low-vaccine specialties, practices with high RCM rates), for most general pediatric practices, I can't recommend their services. 

Still, I wanted practices to do their own math - not trust the proposal the vendors make for you (I've never seen an accurate one, tbh) - so I built a spreadsheet, of course :-)

And while I've been testing it, the federal gov't has decided that Pediatricians Are Now The Money Hungry Enemy.  According to one unfortunately loud individual, "up to 50% of pediatric revenue" (implication: your bank account) comes from vaccines - a demonstrably false statement.  But let's prove it?

Head to this Google sheet and get started! [Should I Sell My Vaccine Business?]

The instructions are below and also in the document.  Please, play with this and give me me feedback!

Instructions:
Are you making or losing money by giving vaccines?  Should you engage with a third party vaccine "delivery platform" instead of managing your own inventory?

The intent of this tool is two-fold.  First, you can use it to determine what, if any, margin you generate from your vaccine business.  Second, you can use it to determine whether or not it's beneficial to have someone else purchase (and profit from) the vaccines you administer to children.

Step 1. Use the 'File' menu to 'Make a Copy' of this sheet so you have your own workspace.  You can come back here to make as many copies as you want (or copy your own over and over).  If you're using the link above, it should automatically force you to make a copy.

Step 2. Gather your data.  You will need:
- invoices from vaccine purchases
- fee schedules/payment information for vaccines and admins from your payors
- and the proposed fees you will be paid from any vaccine service

Step 3. Complete the data for your existing vaccine work and present revenue.  Any field with a colored background is one for you to change or fill in as follows:

Purple:  The purple fields in the upper left (B1/2) are default values for the overhead costs for your vaccine business.  For now, leave them as is (but more details below).

Orange: If you receive rebates for your vaccine purchases as distinct line items, provide the total here.  Otherwise, rebates should be captured in your vaccine costs (Green, below).
Otherwise, rebates should be captured in your vaccine costs (Green, below).

Pink: In columns C and D, put your volume and average revenue (payments) for each vaccine and administration.
Make sure you *exclude* Medicaid/VFC from these numbers (they should be calculated differently, perhaps we will do that later).

Green: In column E, put your average invoice cost for purchasing vaccines.  
Again, if your rebate numbers are part of this figure, record it here, otherwise put the total of your rebates in B5.

Step 4: Complete the data for your vaccine delivery platform proposal.

Yellow: In column K, enter the proposed payment you will receive for administering each vaccine.

NOTE: some vaccine platforms have additional costs that are not reflected in this example.  We're looking at the ideal payment plan, not necessarily the reality.

Step 5: Read and compare.

In rows 3-6, you will then see an estimate of your admin and product margins as well as a comparison to what your vaccine platform might pay.  Compare cells B6 to I6!

Step 6: Adjust your estimated costs.  In purple cell B1 is an estimated figure for the average cost of administering a vaccine.  Previous studies, now decades old, suggest that an average practice spends $11.51 to administer a vaccine (regardless of antigens). https://publications.aap.org/pediatrics/article-abstract/124/Supplement_5/S492/29821/Cost-of-Vaccine-Administration-Among-Pediatric

Presuming some level of inflation as well as increased complexity and challenge, we start at $18-20 - if you think you are amazing at administration, 
perhaps lower the number a little.  If you think your practice is challenged by administration, perhaps raise it.

In purple cell B2 is the estimate of your vaccine product carrying costs, which the AAP recommends is 17-28% more than your invoice price. 
 [Unfortunately, the AAP keeps moving their document so I can't link to it easily.]  
Again, if you are amazing at managing your inventory, perhaps you lower the costs to 17%.  If you are not amazing,  consider increasing them.