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Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: Mightysure on January 12, 2022, 09:25:01 pm

Title: CABENUVA NOT ON FORMULARY
Post by: Mightysure on January 12, 2022, 09:25:01 pm

Hey everybody.

So I am wondering if anyone has any experience with getting coverage for drugs that are not on your insurance formulary.

I've been in a clinical trial for Cabenuva since 2018.  As many of you know, it has now been FDA approved and I have now been rolled off of the trial.

Cabenuva was successful for me. No nasty side effects or blops and it's really something that makes my life eaiser.


Does anyone have any tips on how I should get it approved?

I'm insured through BCBS NC.

Title: Re: CABENUVA NOT ON FORMULARY
Post by: allanq on January 17, 2022, 09:24:48 pm

Check out this website to see if the manufacturer offers financial assistance.

https://www.cabenuva.com/costs-and-resources/cabenuva-support/

Good luck to you!

Title: Re: CABENUVA NOT ON FORMULARY
Post by: Mightysure on February 16, 2022, 03:12:39 pm

Thanks AllanQ.

I coordinated with the manufacturer and my insurance and they came up with a solution.

It will be paid as a medical benefit and not a pharmacy one. Copay assistance from Viiv will pay up to my deductible and then insurance will take over.

Just in case anyone else runs into a similar issue.