Brand Truvada 200/300 mg — United Healthcare
Pre-exposure prophylaxis (PreP)
Preferred products
- Generic Truvada (emtricitabine/tenofovir disoproxil fumarate)
Initial criteria
- For PreP: Brand Truvada 200/300 mg will be used as part of a comprehensive prevention strategy including other prevention measures AND submission of medical records documenting a history of adverse event or intolerance to prior use of generic Truvada (emtricitabine/tenofovir disoproxil fumarate)
- For Non-PreP indications: Submission of medical records documenting Truvada is not being used for PreP and a history of adverse event or intolerance to prior use of generic Truvada (emtricitabine/tenofovir disoproxil fumarate)
Reauthorization criteria
- Documentation of positive clinical response AND member is currently on medication as documented in claims history (evidence of claims in past 120 days)
Approval duration
12 months