Cabenuva — Medical Mutual

Initial criteria

• Patient is ≥ 12 years of age
• Patient weighs > 35 kg
• Patient has HIV-1 RNA < 50 copies/mL (viral suppression)
• Prior to initiating Cabenuva or 1 month lead-in with Vocabria, the patient was treated with a stable regimen (≥ 3 months) of antiretrovirals for HIV-1
• The medication is prescribed by or in consultation with a physician who specializes in the treatment of HIV infection

Reauthorization criteria

• Patient is currently receiving Cabenuva
• Patient has HIV-1 RNA < 50 copies/mL (viral suppression)

Approval duration

1 year