Dolutegravir (Tivicay) Medicare Coverage

Dolutegravir
Chemical name: Dolutegravir

Brand name: Tivicay

Typical dosage: 50mg

Typical type: Tablet1

Dolutegravir is a medication used to treat HIV. Dolutegravir is available as a brand name drug called Tivicay as an oral tablet.

Dolutegravir is the generic form of the medication Tivicay. Dolutegravir is used to treat HIV-1 infection in adults and children who weigh at least 66 lbs. (30 kg.)

Dolutegravir is taken once daily. It works by preventing the HIV virus from replicating in the body.

Common side effects of Dolutegravir include headache, fatigue and insomnia.

Does Medicare cover Dolutegravir or Tivicay?

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

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Average costs for Dolutegravir/Tivicay 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 – $1,890 $42 – $1,865

Additional information

It is important that you do not skip or miss any doses of Dolutegravir in order to properly control your HIV.

Liver problems can happen while taking Dolutegravir. Signs of liver problems include fatigue, loss of appetite, upset stomach, vomiting or yellow skin or eyes.

Talk to your doctor if you experience any of these symptoms. Let your doctor know if you experience fever, muscle or joint pain, mouth sores, eye irritation, shortness of breath or if you feel very tired or weak.

Dolutegravir can lead to changes in your immune system. Tell your doctor if you have any signs of infection like fever, sore throat, weakness, cough or shortness of breath.

 

 

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.