How to Help Your Patients Find Rabies Immune Globulin in Stock: A Provider's Guide

As a healthcare provider managing a potential rabies exposure, one of your key responsibilities is ensuring your patient receives human rabies immune globulin (HRIG) as quickly as possible — ideally on Day 0, and no later than Day 7 of the PEP series. When HRIG is not available at your facility, knowing how to quickly locate it for your patient can be the difference between life and death.

This guide provides a systematic approach to sourcing HRIG for your patients, navigating insurance barriers, and connecting patients with financial assistance programs.

Step 1: Prioritize Starting the Vaccine Series While Locating HRIG

If your facility does not have HRIG in stock, do not delay the vaccine. Administer the first dose of rabies vaccine (RabAvert or Imovax) immediately, then locate HRIG to administer within the Day 7 window. The vaccine series is critical to building active immunity; HRIG provides passive protection while that immunity develops.

Step 2: Where to Find HRIG — A Tiered Approach

Use this tiered approach to locate HRIG for your patient:

Tier 1 — Your own facility's pharmacy or supply chain: Check with your hospital or clinic pharmacy directly. If your facility doesn't routinely stock HRIG, your pharmacy may be able to emergency-order it from a distributor within 24 hours.

Tier 2 — Nearest hospital emergency department: Transfer or refer your patient to a hospital ER that has HRIG in stock. Most Level I and II trauma centers carry it.

Tier 3 — State or county public health department: Contact your local health department. Most states have a 24-hour rabies consultation line and can coordinate access to HRIG, especially in rural areas. Your state epidemiologist's office is also a resource.

Tier 4 — Manufacturer emergency supply: Contact manufacturers directly for emergency availability. Grifols (HyperRAB): 1-800-520-2807. Kedrion/Kamada (KedRAB): 1-855-353-7466. Sanofi (Imogam): 1-800-822-2463.

Using medfinder to Locate Stocking Facilities for Your Patients

For providers whose patients need to locate a facility stocking HRIG independently, medfinder for providers is a service that contacts facilities near your patient and identifies which ones have specific medications available. Rather than spending time on hold with multiple facility pharmacies, you or your staff can use medfinder to quickly narrow down options — important when every hour in the PEP window counts.

Navigating Insurance for HRIG: What Providers Need to Know

Most commercial insurers, Medicare, and Medicaid cover rabies PEP when medically necessary after a documented exposure. However, coverage details vary:

Hospital setting: HRIG administered during an emergency department visit is typically covered under the facility's ER or inpatient benefit — less likely to require prior authorization.

Outpatient setting: Some plans require prior authorization for PEP in outpatient clinics. Document the nature of the exposure clearly (animal type, bite location, whether animal was captured for testing) to support medical necessity.

Uninsured patients: Direct patients to manufacturer patient assistance programs (see below) and state public health departments.

Patient Assistance Programs for HRIG

All three HRIG manufacturers offer patient assistance programs for patients who cannot afford treatment:

Sanofi (Imogam Rabies-HT): Has supplied HRIG at no charge to patients in need, including resupply directly to hospitals. Contact through Sanofi patient services or 1-800-822-2463.

Grifols (HyperRAB): Contact Grifols Therapeutics at 1-800-520-2807 for patient assistance options.

Kedrion/Kamada (KedRAB): Contact Kedrion Biopharma at 1-855-353-7466.

Important: Do not advise patients to delay PEP due to cost concerns. The risk of untreated rabies — a nearly universally fatal disease — far outweighs any financial barrier. Help patients identify assistance proactively, even while initiating treatment.

Documenting Rabies Exposures for Reporting and PEP Coordination

Rabies is a reportable disease in all 50 states. When you initiate PEP, notify your state or local health department. Public health officials can:

Coordinate quarantine or testing of the animal involved

Help source HRIG if unavailable at your facility

Advise on whether PEP is indicated (e.g., low-risk situations where a bat was in the same room but no confirmed contact)

Track the follow-up vaccine doses and coordinate care across facilities if needed

Summary Checklist for Providers

Start vaccine series immediately regardless of HRIG availability

Administer HRIG at 20 IU/kg on Day 0, or as soon as available (up to Day 7)

Verify HyperRAB (300 IU/mL) vs. KedRAB/Imogam (150 IU/mL) dosing before administration

Never give HRIG and vaccine in the same syringe or same site

Report the exposure to your state or county health department

Connect patients with manufacturer PAPs if cost is a barrier

Use medfinder to locate nearby stocking facilities if HRIG is not at your facility

See also: Rabies Immune Globulin Shortage: What Providers Need to Know in 2026