The bronchiolitis epidemic arrives in Occitania: why access to Beyfortus can be very expensive for parents

De plus en plus de cas de bronchiolite à l’approche de l’hiver. Midi Libre – MIKAEL ANISSET

Parents have up to 300 euros left to pay to vaccinate their baby. Incomprehensible for the pediatric community and penalizing for the most modest families, Occitanie has just switched, this Wednesday, December 4, to epidemic alert for bronchiolitis, according to Public Health France.

“Last year, the treatment was not available, but it was reimbursed at 100%. This year, it is available, but health insurance only covers 30% of it”: the bronchiolitis epidemic, which until now has spared Occitanie, is arriving in the region in a context of controversy over access to Beyfortus, the preventive treatment now available to protect babies.

In its bulletin of December 4, Santé Publique France places the region in “red” for the first time this fall.

Brigitte Virey, national president of the pediatricians' union, raises the debate, a dilemma for parents relayed by the pediatric community: “Restricting access to nirsevimab (better known to the general public under the name Beyfortus), by limiting its reimbursement seems unacceptable to pediatric learned societies, which believe that it is essential, from an ethical and public health point of view, to protect all infants and newborns, including the most precarious and vulnerable,” are concerned, in a joint statement, by pediatricians, who want to avoid “hospitalizations avoidable”.

Granted European marketing authorization since October 2022 and available a year later, Beyfortus has revolutionized the treatment of bronchiolitis: in 80% of cases, an injection prevents RSV, the respiratory syncytial virus, “the cause of 80% of bronchiolitis, from infecting the bodies of newborns”, specifies the health insurance on its website.

Beyfortus is effective a few days after an injection. Health insurance hails its effectiveness against serious cases, based on a study conducted by the Pasteur Institute and Public Health France: 5,800 hospitalizations avoided between September 15, 2023 and January 31, 2024 in France.

“In “real life”, it works”

“This is an observation that we make in our “real life” as doctors, Beyfortus works!” , insists Brigitte Virey, who points out that if the vaccination is not done at the maternity ward, the remaining cost to the parents is around 300 euros, “not all mutual insurance companies cover it, and we are unable to specify which ones”, insists the pediatrician, who is surprised by the low level of coverage: the reimbursement rate depends on the medical service provided, it is 100% for drugs described as irreplaceable and expensive, the 30% base corresponds to an effectiveness “moderate”.

“Incomprehensible”, for Brigitte Virey, who points out that all childhood vaccines are much better reimbursed, “100% for MMR, 65% for the others”.

“This story of medical service rendered raises questions for us”, concludes the pediatrician, who is worried about a “renunciation of care” : “I have contacted the general management of the provision of care, they are reviewing their position for next year”.

In the meantime, parents of babies are penalized, and pharmacists sometimes navigate blindly: “It is impossible to know if the insured will be reimbursed by reading their mutual insurance card” regrets Christelle Quermel, pharmacist in Montpellier, and president of the pharmacists' union of Hérault, who discovered this problem of the remaining charge this week, while “many families” wanted to protect their child before the winter epidemic arrived.

A mother who had ordered the vaccine gave up when she discovered that it would cost her 300 euros. “I told her “Are you sure?” It's incredible, when the vaccine is effective”, the pharmacist is moved.

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