Alliance for Patient Access / IfPA’s Patient Access Policy Blog / NCfIH Marks RSV Awareness Month with Release of New “Fast Facts”

NCfIH Marks RSV Awareness Month with Release of New “Fast Facts”

October marks the beginning of both the RSV viral season and RSV awareness month. The National Coalition for Infant Health is taking the opportunity to release a new “Fast Facts” educational resource on the virus, its impact, and its danger for infants, especially preemies whose health plans don’t cover preventive treatment.

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As the Fast Facts explains, respiratory syncytial virus is a contagious seasonal virus that causes respiratory infections. It often affects infants and toddlers; most children get RSV by age two. Though many infants can fight off the virus, preemies with weak immune systems are at greater risk.

Preemies’ small, underdeveloped airways make them vulnerable to respiratory problems. And their immature immune systems may be unequipped to fight off the virus. Perhaps for those very reasons, the paper explains, RSV is the leading cause of hospitalization in babies less than one year old and, across the globe, the second leading cause of infant mortality outside the neonatal period.

Disparities and Access to Preventive Treatment

African American and low-income infants are at greater risk of RSV. For African Americans, RSV is more common because of higher rates of prematurity and low birthweight, even among full-term babies. For low-income families, risk factors such as living in densely populated urban areas, exposure to air pollutants and crowded living conditions can increase the risk of RSV. Low-income parent may be forced to increase their child’s RSV risk by using public transportation or relying on daycare facilities as they work to support the family.

Some health plan coverage introduces another form of disparity – the RSV coverage gap. Preventive treatment known as “palivizumab” can reduce the severity of an RSV infection, decreasing hospitalizations by 55 percent. But some public and private health plans will pay for treatment only for severely premature infants born before 29 weeks gestation. The NCfIH explores the coverage gap in its video “The Gap Baby.”

RSV Impact

The result of coverage gaps is alarming. The Fast Facts explains that the first RSV season after the creation of coverage gap policies found “709 hospitalized ‘gap babies,’ infants born at 29 to 35 weeks who were likely denied coverage for preventive treatment.” Research shows that RSV hospitalizations for preemies come at a much higher cost than those for their full-term peers, that preemies have longer RSV hospital stays and that more preemies are admitted to the intensive care unit.

Meanwhile, the disease also takes a toll on families. An infant’s hospitalization may require parents to miss work, sacrifice wages and face added expenses for logistics and transportation to the NICU and back. The paper notes that families also experience an emotional impact. “To reduce RSV’s impact on premature infants and their families,” the paper concludes, “policymakers must work to improve health plan coverage for preventive RSV treatment.”

To learn more, read “Fast Facts: Respiratory Syncytial Virus.”

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