Publicly Funded Drug Programs
Respiratory Syncytial Virus Prophylaxis for High-Risk Infants Program
Through the Respiratory Syncytial Virus Prophylaxis for High-Risk Infants Program, the Ministry of Health and Long-Term Care covers the full cost of the drug palivizumab used to prevent a serious lower respiratory tract infection caused by the Respiratory Syncytial Virus (RSV) in infants who are less than 2 years of age at the start of the RSV season and who are at high risk for RSV disease.
The drug is only provided during the active season to infants who meet the ministry's eligibility criteria for funding. The active season is generally from November to April, with variations in various regions of Ontario.
Palivizumab will be funded for RSV prophylaxis in infants who are residents of Ontario, have a valid Ontario health card and if they meet one of the following clinical criteria :
- Infants born prematurely at ≤ 32 completed weeks gestation and aged ≤ 6 months at the start of, or during, the local RSV season; or
- Infants 33 – 35 completed weeks gestation and aged ≤ 6 months at the start of, or during the local RSV season, who DO NOT live in isolated communities AND have a Risk Assessment Tool Score of 49 to 100; or
- Infants 33 – 35 completed weeks gestation and aged ≤ 6 months at the start of, or during the local RSV season, and who LIVE IN isolated communities where paediatric hospital care is not readily accessible and ambulance transportation for hospital admission is required; or
- Infants < 24 months of age with Down Syndrome / Trisomy 21; or
- Infants < 24 months of age with bronchopulmonary dysplasia/chronic lung disease (BPD/CLD) and who required oxygen and/or medical therapy within the 6 months preceding the RSV season; or
- Infants < 24 months of age with hemodynamically significant (HS) cyanotic or acyanotic congenital heart disease (CHD); requiring corrective surgery or is on cardiac medication for hemodynamic significant disease.
Infants with other specific medical illnesses that places them at high risk of hospitalizations and complications from a RSV infection may also be considered for prophylaxis, if they meet necessary requirements. The enrolment forms for these infants will be reviewed on a case-by-case basis by the ministry's medical consultant(s) with expertise in RSV prophylaxis.
The following are the links to the guidelines, general information, answers to frequently asked questions and applicable forms for the current RSV prophylaxis season for health care professionals:
Information and Guidelines
- 2015-2016 RSV Prophylaxis Season Information to healthcare professionals (PDF)
- 2015-2016 Season Enrolment and Drug Ordering Process (PDF)
- RSV Prophylaxis Program Frequently Asked Question (PDF)