Homecare Update

(From the August 2024 Issue of MedStat)

Use of Single Dose Nirsevimab (Beyfortus™) for RSV

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) met in June of this year and made no changes in recommendations for infant prophylaxis with monoclonal antibodies such as nirsevimab. A study published March 7, 2024, in Morbidity and Mortality Weekly Report, showed nirsevimab is 90% effective at preventing RSV-associated hospitalization for infants in their first RSV season. Nirsevimab is recommended for infants up to 8 months old during their first RSV season and for high-risk toddlers aged 8 to 19 months in their second RSV season. The recommended dosage is 50 mg for infants born during or entering their first RSV season and weighing <5 kg (<11 lb.); for those weighing ≥5 kg (≥11 lb.), the recommended dosage is 100 mg. The recommended dosage for infants and children aged 8–19 months at increased risk for severe disease entering their second RSV season is 200 mg (2 x 100 mg injections).

Last year, during RSV season the nirsevimab supply was not sufficient. However, the expectation is there should be no supply shortages for the 2024-2025 RSV season.

Historically, Nationwide Children's Homecare provided on average 150 mg of palivizumab (Synagis®) per dose for five doses during the RSV season at an Average Wholesale Price (AWP) that totaled $31,550 for the season, compared to the one dose nirsevimab (Beyfortus™)50 mg or 100 mg at an AWP of $624 for the season. Efficacy and cost would indicate use of nirsevimab, in addition to the CDC's recommendations.

Homecare will keep vigilant if nirsevimab supply changes indicate that palivizumab would be needed. The American Academy of Pediatrics (AAP) will be releasing additional recommendations for the 2024-2025 RSV Season, as will the ACIP. Updates from AAP and ACIP and links to other resources are available at the Homecare webpage.

For questions regarding referral processes or any Homecare services or programs, email Carolyn Figi.