enfuviride — CareFirst (Caremark)
Human immunodeficiency virus type 1 (HIV-1) infection
Initial criteria
- Member has viremia despite ≥3 months of therapy with at least one appropriate regimen used to treat HIV
- OR Member has viremia and documented resistance or intolerance to at least one appropriate regimen used to treat HIV
Reauthorization criteria
- Member has had a positive or stable virologic response to Fuzeon
Approval duration
12 months