Biktarvy Medicare Coverage

Biktarvy
Chemical name: Bictegravir/Emtricitabine/Tenofovir alafenamide

Brand name: Biktarvy

Typical dosage: 50mg/200mg/25mg

Typical type: Tablet1

Biktarvy is a medication used to treat HIV infection. Biktarvy is available in brand name form only and comes as an oral tablet.

Biktarvy is a medication that contains the active ingredients bictegravir, emtricitabine and tenofovir alafenamide. Biktarvy is used to treat HIV infection as a complete regimen in adults and children.

Biktarvy is an oral tablet that is taken once daily. The medications in Biktarvy work together to prevent the HIV-1 virus from replicating in the body.

Biktarvy is typically well tolerated but can cause diarrhea, upset stomach and headache.

Does Medicare cover Biktarvy?

Yes! 100% of Medicare Advantage plans and Medicare Part D plans cover Biktarvy.1

  • Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.2

  • Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Biktarvy.

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Average costs for Biktarvy with Medicare drug coverage1

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in.

Deductible stage Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs.

In the deductible stage, you’re responsible for the full cost of your prescription drugs.

Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.
After you meet your Part D deductible, you enter the initial coverage period.

During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.
$42 – $3,227 $42 – $3,227

Additional information

Suppressing your viral load requires you to take Biktarvy every day as your doctor prescribes it. Missing doses can allow the HIV virus to replicate and make your condition worse.

Talk to your doctor if you experience any kidney or liver problems while taking Biktarvy. Signs of kidney or liver problems include dark urine, yellowing of the eyes and skin, problems urinating, blood in the urine or stomach pain.

Biktarvy can cause a condition where too much acid is present in your blood, called lactic acidosis. Signs of lactic acidosis include an abnormal heartbeat, fatigue, dizziness, feeling cold or muscle cramps.

Biktarvy does not stop the spread of HIV through contact with infected blood or through sexual intercourse.

 

 

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

 

Written by Hayden Gharibyar, Pharm.D.