Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

Complera not on preferred drug list


So I just found out from talking to someone at Accredo that Complera is not on my insurance plans preferred drug list!! WTF...I had called in a refill last week and when it still hadn't been delivered by when they said it was ..I was informed that my dr needed to call with an authorization(which supposedly is a new thing) he did that! Still no delivery and then I called tonight and she informed of this atrocity. Its gonna be a long weekend waiting to call BCBS on Monday to find out if this is true. I am freaking out! Has anyone else had this problem happen to them? I hope it is not true...if it is I don't know what to do.

I just checked bcbs Texas Rx coverage list.  Complera is one of the few HIV drugs categorized as non-preferred brand, but it's still covered.  Pre auth is not required.

Can you check bcbs online for your State?

Could you get around this by taking the components of Complera (rilpivirine + tenofovir + emtricitabine) in the form of Edurant (rilpivirine) and Truvada (tenofovir + emtricitabine)? Would doing that seriously affect your co-pay?

You'd take it the same exact way as Complera - once a day with food. You'd just be taking two pills instead of one.

I suspect this is the crux of why you're having trouble with it - Complera vs Edurant + Truvada is a convenience issue rather than a efficacy issue, medically speaking. Financially speaking it may be a problem for some if they can't afford an increase in co-pay.

You can read about the various forms of your combo here.

Good luck.

I had to go through the hoops and the forms and then they approved it with a higher co-pay... Thank goodness for the co-pay card.


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