Form Hhs-699 - Discrimination Complaint - Department Of Health And Human Services - Office For Civil Rights (Ocr) Page 10
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used broadly by providers who work with HIV-positive patients.
Under these Guidelines, there
are currently six treatment regimens used for adult and adolescent treatment-naïve patients (i.e.,
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those who have not taken HIV medications before):
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1. dolutegravir
+ (abacavir + lamivudine)
= Triumeq (STR).
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2. dolutegravir + Truvada (tenofovir DF plus emtricitabine)
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3. elvitegravir
+ cobicistat
+ tenofovir alafenamide
+ emtricitrabine = Genvoya (STR)
4. elvitegravir + cobicistat +( tenofovir DF + emtricitrabine) = Stribild (STR)
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5. raltegravir
+ Truvada (tenofovir DF plus emtricitabine)
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6. darunavir
+ ritonavir
+ Truvada (tenofovir DF plus emtricitabine)
Thus, in order to ensure the ability of providers to prescribe treatment consistent with the
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prevailing standard of care, formularies must currently provide access to sixteen primary drugs.
Having an exceptions process to the formulary through which an individual can attempt to access
coverage for a drug not on the formulary, prescribed before enrollment, is not enough. This is true
because of the uncompensated cost to providers of going through the prior authorization
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See id. at A-1
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See id. at F-3.
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Dolutegravir is an integrase inhibitor (INSTI) with a brand name product Tivicay.
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Abacavir alone is a Nucleoside Reverse Transcriptase Inhibitor (NRTI) with a brand name of Ziagen. Lamivudine
alone is also a NRTI with the brand name of Epivir. Abacavir + lamivudine together are an NRTI with a brand name
Epzicom.
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Tenofovir disoproxil fumarate (DF) alone is an NRTI with the brand name Viread. Emtricitabine is an NRTI with
a brand name of Emtriva. Tenofovir DF plus emtricitabine is an NRTI with the brand name Truvada.
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In certain cases where emtricitabine is part of the combination drug, lamivudine can be substituted.
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Elvitegravir is an integrase inhibitor (INSTI) with a brand name product Vitekta.
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Cobicistat is a pharmacokinetic enhancers with a brand name of Tybost.
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Tenofovir alafenamide is a prodrug of the NRTI tenofovir.
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Raltegravir is an integrase inhibitor (INSTI) with a brand name product Isentress.
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Darunavir is a protease inhibitor (PI) with a brand name product Prezista.
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Ritonavir is a PI with a brand name product Norvir.
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These 16 primary drugs are as follows:
Tivicay (brand name) – dolutegravir (no generic version available);
abacavir (generic name) – also available in sulfate form as brand name Ziagen;
lamivudine (generic name) – also available as brand name Epivir;
Epzicom (brand name) - abacavir + lamivudine;
Triumeq (brand name) – STR of dolutegravir + (abacavir + lamivudine);
tenofovir DF (generic name) – also available as brand name Viread;
Emtriva (brand name) – emtricitabine (no generic version available); but note that
lamuvidine may
be substituted in certain circumstances;
Truvada (brand name) – tenofovir DF + emtricitabine;
Viteka (brand name) – elvitegravir – (no generic version available);
Tybost (brand name) – cobicistat – (no generic version available);
Descovy (brand name) - tenofovir alafenamide + emtricitabine;
Genvoya (brand name) - STR of elvitegravir + cobicistat + (tenofovir alafenamide + emtricitabine);
Stribild (brand name) - STR of elvitegravir + cobicistat + (tenofovir DF + emtricitabine);
Isentress (brand name) – raltegravir (no generic version available);
Prezista (brand name) – darunavir - (no generic version available);
Ritonavir (generic name for tablet) – also available in tablet / capsule / solution form as brand name Norvir.
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