What is Rapivab (Peramivir)?
Rapivab, with the active drug name peramivir, is an antiviral medication used to treat acute uncomplicated influenza (the flu) [1.8.1]. It belongs to a class of drugs known as neuraminidase inhibitors, which work by preventing the influenza virus from spreading from infected cells to other cells in the body [1.6.1, 1.7.5]. A key feature of Rapivab is its administration; it is given as a single intravenous (IV) infusion over 15 to 30 minutes [1.6.2, 1.8.4]. This makes it a distinct option from oral antivirals. The FDA has approved Rapivab for patients aged six months and older who have experienced flu symptoms for no more than two days [1.8.2, 1.8.6].
Efficacy and Use Cases
Clinical trials have shown that Rapivab can reduce the duration of flu symptoms. In one study, patients receiving Rapivab saw their symptoms alleviate about 21 hours sooner than those who received a placebo [1.7.3]. Its efficacy has been established in cases of naturally occurring influenza, primarily against Influenza A strains [1.8.1]. However, its effectiveness has not been established for patients with serious influenza that requires hospitalization [1.8.1, 1.8.4]. Because it is an IV treatment, it is often considered for patients who are unable to take oral medications [1.5.3].
How Much Does Rapivab Cost Without Insurance?
The cash price of Rapivab can be substantial. The average retail price for a single 600 mg dose is often cited as being between $930 and over $1,000 [1.2.1, 1.2.5, 1.3.1]. Some sources indicate an average retail price can be much higher, though discount cards can lower this cost significantly [1.2.1]. For example, a coupon price for a 60mL vial of 10mg/mL solution can be around $935 [1.3.1].
It is crucial to understand that this list price does not include the additional costs associated with its administration. Because Rapivab is an IV drug, the total cost to the patient will also include:
- Facility Fees: Charges from the hospital or outpatient clinic where the infusion is given.
- Administration Fees: Costs for the healthcare professional's time to prepare and administer the IV.
- Associated Medical Supplies: The cost of the IV line, saline solution, and other necessary equipment.
These factors can add several hundred dollars or more to the final bill, making the total out-of-pocket cost much higher than the drug's sticker price.
Rapivab vs. Other Antivirals: Cost & Feature Comparison
When considering flu treatment, it's helpful to compare Rapivab with other common antiviral medications like Tamiflu (oseltamivir) and Xofluza (baloxavir marboxil). As of late 2025, Rapivab does not have a generic version available, which contributes to its higher cost [1.7.1, 1.7.4]. The earliest a generic might become available is estimated to be 2027 [1.7.6].
| Feature | Rapivab (peramivir) | Tamiflu (oseltamivir) | Xofluza (baloxavir) |
|---|---|---|---|
| Administration | Single Intravenous (IV) Infusion [1.5.3] | Oral Capsules/Liquid [1.5.3] | Single-Dose Oral Tablets [1.5.1] |
| Typical Regimen | One dose [1.8.4] | Twice daily for 5 days [1.8.5] | One dose [1.5.1] |
| Generic Available? | No [1.7.1, 1.7.2] | Yes [1.3.6] | No [1.5.1] |
| Approx. Cash Price (Drug Only) | ~$935+ [1.3.1] | ~$25-$60 (generic) [1.5.5] | ~$150-$200 [1.5.6] |
Insurance Coverage and Patient Assistance
Insurance coverage for Rapivab varies widely between plans [1.2.1]. Many Medicare Part D plans do not cover the drug itself, but it may be covered under Medicare Part B when administered in a clinical or hospital setting [1.4.1]. Commercial insurance plans may require prior authorization, where the prescriber must justify the need for an IV antiviral over a less expensive oral option.
For patients facing high costs, the manufacturer, BioCryst Pharmaceuticals, may offer patient assistance programs [1.2.1]. However, specific programs for Rapivab from the manufacturer were not prominently found in search results. Patients can also explore independent charitable programs or prescription discount cards, which can significantly reduce the cash price [1.2.1, 1.4.4].
Common Side Effects
The most common adverse reaction reported in clinical trials for adults was diarrhea, occurring in about 8% of patients [1.6.3]. In pediatric patients, vomiting was a reported side effect [1.6.6]. Rare but serious side effects can include severe skin reactions and neuropsychiatric events like hallucinations or delirium, which have been reported in patients with influenza in general [1.6.4, 1.8.2].
Conclusion: Evaluating the Cost of Rapivab
While the upfront cost of Rapivab is high compared to oral antivirals, its value lies in its specific clinical application. As a single-dose IV treatment, it provides a crucial alternative for patients who cannot take or tolerate oral medications. The total cost is a combination of the drug's high list price—due to its brand-name status with no generic competition—and the significant fees for intravenous administration. For patients, understanding insurance benefits and exploring all available savings options is essential before proceeding with treatment. A conversation with a healthcare provider and insurance company is the best way to determine the final, out-of-pocket expense.
For more information on influenza antiviral medications, you can visit the CDC's official page.
