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Author Topic: Switching from Biktarvy to Dovato...?  (Read 4991 times)

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Offline MrAlwaysAnxious

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  • Posts: 13
  • I survived, and the world deserves to know that.
Switching from Biktarvy to Dovato...?
« on: October 10, 2019, 10:30:38 pm »
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.
Dx: 3/15/19
CD4: 349/33% on 3/20/19
VL: 9,820,000 on 3/20/19
Rx: Started Symtuza on 3/15/19
CD4: 771/39% on 4/16/19
VL: 484 on 4/16/19

Online Jim Allen

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Re: Switching from Biktarvy to Dovato...?
« Reply #1 on: October 11, 2019, 12:53:13 am »
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
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Offline fabio

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  • Posts: 729
Re: Switching from Biktarvy to Dovato...?
« Reply #2 on: October 11, 2019, 06:56:06 am »
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.

Offline FarmBoy

  • Member
  • Posts: 14
Re: Switching from Biktarvy to Dovato...?
« Reply #3 on: October 11, 2019, 11:07:19 am »
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.
7/25/16 - Infected
8/4/16 - Sero-conversion started (flu, then fever, fatigue most of August)
8/29/16 - hospitalized O.N. for dehydration; tested
9/1/16 - Dx'd (confirmed WB 9/2)
9/6/16 - CD4 1395 (15%); VL 275,904; genotyped
10/5/16 - CD4 800 (27%) Started on Triumeq
11/2/16 - CD4 699 (26%); VL <20
1/11/17 - no CD4; VL <20
5/17/17 - CD4 742 (22%); VL <20
11/15/17 - CD4 745 (33%); VL <20
5/16/18 - no CD4; VL <20
11/28/18 - no CD4; VL <20
05/29/19 - no CD4; VL <20
07/01/19 - switched to Dovato
11/20/19 - CD4 835 (32%); VL <20

Offline MrAlwaysAnxious

  • Member
  • Posts: 13
  • I survived, and the world deserves to know that.
Re: Switching from Biktarvy to Dovato...?
« Reply #4 on: October 17, 2019, 03:58:43 pm »
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!
Dx: 3/15/19
CD4: 349/33% on 3/20/19
VL: 9,820,000 on 3/20/19
Rx: Started Symtuza on 3/15/19
CD4: 771/39% on 4/16/19
VL: 484 on 4/16/19

Offline Kangaroo

  • Member
  • Posts: 36
Re: Switching from Biktarvy to Dovato...?
« Reply #5 on: December 17, 2020, 06:31:09 pm »
Hey MrAnxious

Looking forward to hearing about your experience with the new ART.
Looking at the sea again.
Tides they rise and fall and then they rise again.

29/03/2017: Confirmed POZ(VL: N/A CD4: 303)
26/04/2017: VL 66.576 CD4 575)
12/05/2017: Start of DTC + TDF + 3TC
26/06/2017: VL 58 CD4 628,5
20/07/2017: VL Undetectable
09/05/2018: VL UD CD4 650,7@32,5%
08/11/2018: VL UD CD4 617,4@31,4%
29/05/2019: VL UD CD4 677,8@33,3%
12/11/2019: VL UD CD4 730,0@34,6%
30/05/2020: VL UD CD4 801,8@36,7%
11/12/2020: VL UD CD4 652,0@39,1%

Offline JackFlorens

  • New Member
  • Posts: 1
Re: Switching from Biktarvy to Dovato...?
« Reply #6 on: December 23, 2020, 06:06:20 am »
I learned a lot of new things for myself, I think I'll try these drugs

Online Jim Allen

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Re: Switching from Biktarvy to Dovato...?
« Reply #7 on: December 23, 2020, 10:30:44 am »
@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.
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline randym431

  • Member
  • Posts: 1,137
Re: Switching from Biktarvy to Dovato...?
« Reply #8 on: February 12, 2021, 11:25:11 pm »
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.
Diag Sept 2005 VL 1mill, CD4 85, 3%, weight 143# (195# was normal)
Feb 2021, undetectable, weight 215#

Offline TGun

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  • Posts: 58
  • Happy to be alive
Re: Switching from Biktarvy to Dovato...?
« Reply #9 on: February 14, 2021, 10:18:18 am »
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


Offline gorka

  • Member
  • Posts: 98
Re: Switching from Biktarvy to Dovato...?
« Reply #10 on: March 15, 2021, 09:08:47 pm »
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. 

 


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