Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.
Search results for:

nirsevimab

nirsevimab
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Beyfortus SOLUTION, INTRAMUSCULAR 50 mg/0.5 mL, 100 mg/mL      


Comments:

Beyfortus was classified as formulary, restricted to Neonatal ICU patient at discharge to home during the months of October through March

Exclusion criteria: Mother vaccinated with Abrysvo ≥ 14 days prior to birth

 

At HHWC, Beyfortus is offered through the Vaccines for Children (VFC) program at no cost to patients based on the following eligibility criteria:

  • Medicaid/Medicaid eligible
  • Uninsured
  • American Indian or Alaskan Native

 


Reviewed: Sept 2023 (Beyfortus)

Nirsevimab (Beyfortus)


Last updated: Jan. 19, 2024







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