With 2018-2019 respiratory syncytial virus (RSV) season approaching, Harvard Pilgrim would like to remind providers of our policy regarding Synagis (palivizumab), an injection of antibodies used to protect high-risk infants from severe RSV disease.
Synagis requires prior authorization and should be reserved for infants with a history of pre-term birth, and children with chronic lung disease or congenital heart disease. For members who qualify to receive five doses, the first dose is typically administered at the beginning of November and the last dose at the beginning of March to provide protection into April.
Harvard Pilgrim’s preferred specialty vendor, CVS Specialty, will handle dispensing of this medication. To order Synagis, clinicians should complete the appropriate form, found on the Pharmacy prior authorization page on Harvard Pilgrim’s website. Massachusetts and New Hampshire providers will also need to fax a copy of the prescription to CVS Specialty at 800-323-2445, since their state-specific standard forms don’t include a prescription section. However, the form for providers in all other states allows for the capability of including prescription information.
For more information, please visit the Pharmacy section of Harvard Pilgrim’s provider website or call Clinical Pharmacy Services at 617-509-1786.