Switching from Biktarvy to Dovato...?

[MrAlwaysAnxious]

Hello,

I hope everyone has been doing well. It has been about 7 months since I was diagnosed during acute seroconversion, and am undetectable.

I switched from Symtuza to Biktarvy about three or four months ago. I have been doing better on it than Symtuza, and haven't really had an issues with it. My doctor and I talked about switching to Dovato, and I was wondering if anyone had any experience with Dovato?

I am hoping it will have less side effects, but am also a little worried since I know very little about this drug.

[Jim Allen]

Hiya

Dovato contains Dolutegravir + Lamivudine. It's two of the drugs in my regime.
Dolutegravir is okay, I love it but it's not everyone's cup of tea.

Since you are not having issues with the Biktarvy and have only been on it for a very short time was it the Doctor initiate the idea of switching again?

Jim

[fabio]

What issues did you have with symtuza btw?
I will be getting symtuza,since its just one pill instead of the 2 i take. In my case it doesnt really do anything different.

[FarmBoy]

Hi Mr Anxious

Glad to hear you are undetectable and doing well.

I switched to Dovato on July 1 after I used up my Triumeq which I had started on 3 years ago. I had asked my Dr. at my May 27th appointment if I could switch and he agreed to the change.   As Jim stated, Dovato is a 2 drug version of Triumeq I already was taking but without the abacavir.  There has been no difference nor issues for me in switching and I like the idea of taking fewer drugs for the same result.

One reason your doctor may be suggesting the change now is that Dovato (which wasn't widely available yet when you were diagnosed) is the first first-line, single-pill treatment option where the cost is cheaper than what was previously available.  Dropping the abacavir reduced the price $750/month over Triumeq but also, its one less drug going into my body every day with no change in outcome.

It appears that both of these new combo pills are highly effective, have minimal side effects, are well-tolerated and neither has a food requirement.

The difference then is the cost.  In the US, Bictarvy is listed at $3250/month and Dovato is listed at $2295/mo. or $11,500 less per year for the same outcome of suppressing the virus.  So I feel that what any good doctor in the US should do is to consider the cost of treatment if all other factors are the same. (Dovato also is 1 less drug entering your body long-term).  Outrageous drug prices in the US are a major contributor to the health insurance crisis in the US.

Gilead got a head start in approval and promoting Bictarvy.  They know that most doctors won't switch patients.  Also, I notice that they heavily advertise Bictarvy on TV in the evening in our market where Viiv doesn't spend the money on  advertising Dovato on TV - so I assume that they also heavily promote their drug to the doctors to lock in their high price.

Both companies offer co-pay assistance for private insurance:
Bictarvy - $7200/year with no monthly limit.
Dovato - $6250/year with no monthly limit.

Since my max out of pocket on my company provided insurance is $6000/year, I don't pay any cost out of pocket for my medicine either way.  So I see it as benefiting me by taking less medicine and saving my insurance almost $10,000/yr so hopefully premiums won't rise quite as fast.

Either way, it's up to you and your doctor to determine what's best.  As for me, I've had no issues switching to Dovato.

[MrAlwaysAnxious]

What issues did you have with symtuza btw?
I will be getting symtuza,since its just one pill instead of the 2 i take. In my case it doesnt really do anything different.

Hi Fabio,

The only issues I was having while on Symtuza were higher-than-usual liver panel readings, gastrointestinal issues, and nightmares. I will say, I was taking this medication during an acute infection (seroconversion).

Hi Mr Anxious

Glad to hear you are undetectable and doing well.

I switched to Dovato on July 1 after I used up my Triumeq which I had started on 3 years ago. I had asked my Dr. at my May 27th appointment if I could switch and he agreed to the change.   As Jim stated, Dovato is a 2 drug version of Triumeq I already was taking but without the abacavir.  There has been no difference nor issues for me in switching and I like the idea of taking fewer drugs for the same result.

One reason your doctor may be suggesting the change now is that Dovato (which wasn't widely available yet when you were diagnosed) is the first first-line, single-pill treatment option where the cost is cheaper than what was previously available.  Dropping the abacavir reduced the price $750/month over Triumeq but also, its one less drug going into my body every day with no change in outcome.

It appears that both of these new combo pills are highly effective, have minimal side effects, are well-tolerated and neither has a food requirement.

The difference then is the cost.  In the US, Bictarvy is listed at $3250/month and Dovato is listed at $2295/mo. or $11,500 less per year for the same outcome of suppressing the virus.  So I feel that what any good doctor in the US should do is to consider the cost of treatment if all other factors are the same. (Dovato also is 1 less drug entering your body long-term).  Outrageous drug prices in the US are a major contributor to the health insurance crisis in the US.

Gilead got a head start in approval and promoting Bictarvy.  They know that most doctors won't switch patients.  Also, I notice that they heavily advertise Bictarvy on TV in the evening in our market where Viiv doesn't spend the money on  advertising Dovato on TV - so I assume that they also heavily promote their drug to the doctors to lock in their high price.

Both companies offer co-pay assistance for private insurance:
Bictarvy - $7200/year with no monthly limit.
Dovato - $6250/year with no monthly limit.

Since my max out of pocket on my company provided insurance is $6000/year, I don't pay any cost out of pocket for my medicine either way.  So I see it as benefiting me by taking less medicine and saving my insurance almost $10,000/yr so hopefully premiums won't rise quite as fast.

Either way, it's up to you and your doctor to determine what's best.  As for me, I've had no issues switching to Dovato.

Thank you for sharing your experience with Dovato! I recently got it and found out my insurance covers the entire cost of the drug (it did not with Biktarvy and had to use the copay card). I feel a little better after just taking it for two days. I'll report back after about a month and after getting another VL test done!

[Kangaroo]

Hey MrAnxious

Looking forward to hearing about your experience with the new ART.

[JackFlorens]

I learned a lot of new things for myself, I think I'll try these drugs

[Jim Allen]

@JackFlorens

Welcome to the forum, as a new member of the HIV community can you please open an introduction thread and introduce yourself to the forum members.

I hope your not posting in this section as a PrEP or PEP user and, I presume you are living with HIV? So let us know how are you doing, how the treatment is going etc.  It's standard for new members.

Thank you.

[randym431]

I switched from Biktarvy to Dovato two months ago due to weight issues I encountered with Biktarvy. Now on Dovato, I have not lost any weight on Dovato but the weight I have is no longer so much in the gut. That hard fat gut has changed to what I feel is a more normal softer fat. Like the more typical body fat. Hard to explain, but the weight and fat is different now, and I noticed a lot less cellulite in the rear and legs. I am 5'11" @ 215#. I had been at 200# forever when on Atripla but the doc suggested the newer med, Biktarvy. Then the weight issue began. So as for Dovato, switching I had no issues other than I have returned back to those weird intense night dreams which I have not experienced since taking Truvada. So for me the downside to Dovato was the weird intense dreams returning. And I feel more of that brain-fog from the earlier med days when now on Dovato. No, I do not like the fog and the dreams, not at all, but I will stick with Dovato and give it more time. I do not agree with the FEWER INGREDIENTS IS BETTER pitch. That sounds like a marketing ploy to me. Two or three, I say that if it works it works. Other than the weight thing, I feel that Biktarvy was far superior with no side effects other than that darn weight issue. I'd would definitely go with Biktarvy if the weight issue was not the issue. I kinda worry about Dovato long term being a two regiment pill vs a three. But like I said, I'll give Dovato some more time.

[TGun]

watching this thread closely,, i too have been curoious to switch from biktarvy to dovato, primarily cause of the weight gain... im up about 15 lbs since DX, and its impossible to lose.  any other experiences from people please post them for those of us looking to do this

[gorka]

i switched last year to dovato.  I gained a lot of weight on biktarvy like 50-60 lbs.  I have not lost any yet on Dovato.  I get occasional diarhea which i am not sure if its due to dovato ( I read somewhere lamuvidine can cause it) but other than that i also agree with one poster that i feel as if my fat is becoming softer vs hard when on biktarvy.  i felt like geese getting bigger and bigger even though i was eating the same as before.  and i was newly diagnosed so dont buy "your body was fighting an infection" (got infected in dec 2015 when i had neg test and tested positive in march 2016 w no viremia or high viral count).  new studies are showing that integrase inhibitors contribute to weight gain although mechanism is unknown at this point.  I prefer to take less drugs if i can so dovato was the right choice for me. 

[TGun]

bump,,,


im finally due to start my DOVATO in a few weeks and just curious if anyone had any information to add to this topic here, thanks

[TGun]

well just thought i would update you all with my changes from the biktarvy to dovato.  i been on the dovato for 8 weeks now and I can say for sure that the muscle stiffness/soreness is significantly less and I have also lost 5 pounds body weight... no negative side effects that i notice up until this point.. hope this helps someone out there.

[gorka]

I can add I have not lost any weight i gained while taking biktarvy wince switching to dovato about 2 years ago. but have no side effects from it.  if i was doing it again i would have switched earlier if i could have

[Dogman]

TGun,

I switched today, from Biktarvy to Dovato on the 2 medicines line from my Dr. Not for any other reason. I was treatment naiive when I started Biktarvy 10 months ago. I will get my labs done a month in to see. I had really no major side-effects from Biktarvy and was UD within 3 weeks from a VL of 100,000.   I'm following closely as I'm anxious and am interested in others commentary as well on their experiences.

[TGun]

dogman,

good for you,, yea ive had nothing bud a good experience thus far on dovato.  I finally figured out how to lose some weight,, started intermittent fasting,,, its works for me thus far,,, down about 15 plus in 3 weeks... looking back over my labs over the years it looks like by liver panel numbers are alot better now that im on dovato also.. best of luck!

[Dogman]

Hi, I just posted an update on my switch from bik to dovato. Like you, I'm extremely anxious all the time, still.