Vaccine |
Brandname/
Tradename |
NDC |
Packaging |
CDC |
Private Sector Cost/ |
Contract End Date |
Manufacturer |
Contract Number |
INR COST |
Cost/ |
Dose |
|
Dose |
|
|
|
Tripedia® |
49281-0298-10 |
10 pack - 1 dose vials |
$13.25 |
$23.68 |
3/31/2012 |
Sanofi
Pasteur |
200-2011-38199 |
1184 |
Daptacel® |
49281-0286-10 |
10 pack - 1 dose vials |
$14.51 |
$24.40 |
|
Infanrix® |
58160-0810-11 |
10 pack - 1 dose vials |
$14.85 |
$20.96 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
1048 |
58160-0810-52 |
10 pack - 1 dose T-L
syringes. No Needle |
$14.85 |
$21.44 |
|
Kinrix® |
58160-0812-11 |
10 pack - 1 dose vials |
$34.25 |
$48.00 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
2400 |
58160-0812-52 |
10 pack - 1 dose T-L syringes |
$34.25 |
$48.00 |
DTaP-Hep B-IPV |
Pediarix® |
58160-0811-52 |
10 pack - 1 dose T-L
syringes, No Needle |
$51.15 |
$70.72 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
3536 |
|
Pentacel® |
49281-0510-05 |
5 pack - 1 dose vials |
$52.55 |
$77.48 |
3/31/2012 |
Sanofi Pasteur |
200-2011-38199 |
3874 |
e-IPV |
IPOL® |
49281-0860-10 |
10 dose vial |
$11.97 |
$25.43 |
3/31/2012 |
Sanofi Pasteur |
200-2011 -38199 |
1271.5 |
|
Comvax® |
00006-4898-00 |
10 pack - 1 dose vial |
$29.50 |
$43.56 |
3/31/2012 |
Merck |
200-2011-38200 |
2178 |
|
Vaqta® |
00006-4831-41 |
10 pack - 1 dose vial |
$14.25 |
$30.37 |
3/31/2012 |
Merck |
200-2011-38200 |
1518.45 |
|
Havrix® |
58160-0825-11 |
10 pack - 1 dose vials |
$14.25 |
$28.74 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
1437 |
58160-0825-52 |
10 pack - 1 dose T-L
syringes. No Needle |
$14.25 |
$28.74 |
Hepatitis A-Hepatitis B 18 only |
Twinrix® |
58160-0815-11 |
10 pack - 1 dose vials |
$47.50 |
$89.85 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
4492.5 |
58160-0815-52 |
10 pack - 1 dose T-L syringes, No
Needle |
$47.50 |
$89.85 |
|
Engerix B® |
58160-0820-11 |
10 pack - 1 dose vials |
$10.35 |
$21.37 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
1068.5 |
|
58160-0820-52 |
10 pack - 1 dose T-L
syringes, No Needle |
$10.35 |
$21.37 |
Hepatitis B |
Recombivax |
00006-4981-00 |
10 pack - 1
dose vials |
$10.50 |
$23.20
|
3/31/2012 |
Merck |
200-2011-38200 |
1160 |
Pediatric/Adolescent |
HB® |
|
PedvaxHIB® |
00006-4897-00 |
10 pack - 1 dose vials |
$11.64 |
$22.77 |
3/31/2012 |
Merck |
200-2011-38200 |
1138.5 |
|
ActHIB® |
49281-0545-05 |
5 pack - 1 dose vials |
$9.00 |
$24.29 |
3/31/2012 |
Sanofi Pasteur |
200-2011-38199 |
1214.5 |
Hib |
Hiberix® |
58160-0806-05 |
10 pack - 1 dose vials |
$8.98 |
$22.83 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
1141.5 |
HPV - Quadrivalent Human Papillomavirus Types 6, 11, 16 and 18
Recombinant |
Gardasil® |
00006-4045-41 |
10 pack – 1 dose vials |
$108.72 |
$130.27 |
3/31/2012 |
Merck |
200-2011-38200 |
6513.5 |
HPV
-Bivalent Human Papillomavirus Types 16 and 18 |
|
Cervarix® |
58160-0830-46 |
5 pack-1 dose syringe |
$96.08 |
$128.75 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
6437.5 |
Meningococcal Conjugate (Groups A, C, Y and W-135) |
Menactra® |
49281-0589-05 |
5 pack - 1 dose vial |
$82.12 |
$106.49 |
3/31/2012 |
Sanofi Pasteur |
200-2011-38199 |
5324.5 |
Meningococcal Conjugate (Groups A, C, Y and W-135) |
Menveo® |
46028-0208-01 |
5 pack - 1 dose vial |
$82.12 |
$106.49 |
3/31/2012 |
Novartis |
200-2011-38204 |
5324.5 |
Measles, Mumps and Rubella (MMR) |
MMRII® |
00006-4681-00 |
10 pack - 1 dose vials |
$18.99 |
$50.16 |
3/31/2012 |
Merck |
200-2011-38200 |
2508 |
Pneumococcal |
Prevnar 13 TM |
00005-1971-02 |
10 pack – 1
dose syringes, No Needle |
$97.21 |
$114.15
|
3/31/2012 |
Pfizer |
200-2011-38203 |
5707.5 |
|
(Pediatric) |
Pneumococcal
Polysaccharide (23 Valent) |
|
Pneumovax® |
00006-4943-00 |
10 pack - 1 dose vials |
$34.54 |
$56.31 |
3/31/2012 |
Merck |
200-2011-38200 |
2815.65 |
Rotavirus, Live, Oral, Pentavalent |
RotaTeq® |
00006-4047-41 |
10 pack - 1 dose 2mL
tubes |
$59.76 |
$69.59 |
3/31/2012 |
Merck |
200-2011-38200 |
3479.5 |
00006-4047-20 |
25 pack – 1 dose 2mL
tubes |
$59.76 |
$69.59 |
Rotavirus, Live, Oral, Oral |
Rotarix® |
58160-0854-52 |
10 pack - 1 dose vials |
$89.25 |
$102.50 |
3/31/2012 |
GlaxoSmithKline |
200-2011-38201 |
5125 |
Tetanus & Diphtheria Toxoids |
|
Decavac® |
49281-0291-10 |
10 pack - 1 dose
syringes |
$16.50
|
$20.39
|
3/31/2012 |
Sanofi
Pasteur |
200-2011-38199 |
1019.5 |
No Needle |
49281-0291-83 |
10 pack – 1 dose vials |
$16.50 |
$20.39 |
Tetanus & Diphtheria Toxoids |
MassBiologics |
14362-0111-03 |
10 pack - 1 dose vials |
$15.00 |
|
3/31/2012 |
MassBiologics |
200-2011-38202 |
0 |
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular
Pertussis |
|
Boostrix® |
58160-0842-11 |
10 pack - 1 dose vials |
$29.59 |
$37.55 |
######## |
GlaxoSmithKline |
200-2011-38201 |
$1,877.50 |
58160-0842-52 |
10 pack - 1 dose TL
syringes, |
$29.59 |
$37.55
|
|
|
|
$1,877.50 |
No Needle |
$0.00 |
Tetanus Toxoid, Reduced Diphtheria Toxoid and
Acellular Pertussis |
Adacel® |
49281-0400-10 |
10 pack - 1 dose vials |
$29.59 |
$38.83 |
######## |
Sanofi Pasteur |
200-2011-38199 |
$1,941.50 |
49281-0400-15 |
5 pack - 1 dose BD
Leur-Lok syringes |
$29.59 |
$38.83 |
|
|
|
$1,941.50 |
|
Varivax® |
00006-4827-00 |
10 pack - 1 dose vials |
$69.73 |
$83.77 |
3/31/2012 |
Merck |
200-2011-38200 |
$4,188.50 |
Vaccine
cost includes $2.25 dose Federal Excise Tax |
|
Vaccine cost includes $3.00 per dose Federal Excise Tax |
|
|
Vaccine
cost includes $1.50 per dose Federal Excise Tax |
|
Vaccine cost includes $3.75 per dose Federal Excise Tax |
|
|
Vaccine cost includes $0.75 per dose Federal Excise Tax |
|
|
Vaccines
which contain Thimerosal as a preservative |
|