APRETUDE is covered by most private insurers and Medicaid*
- Covered for more than 9 of 10 patients on commercial insurance
- Covered for the majority of Medicaid patients
*For those with coverage under the medical benefit. Covered means any potential for reimbursement from a health plan and may include step edits, prior authorizations, and other restrictions. Consumers may be responsible for varying out-of-pocket costs based on an individual’s plan and its benefit design. Insurance plans vary. Source: Coverage data are provided by Managed Markets Insight & Technology, LLC, as of July 2023.
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Confirming Insurance Coverage
APRETUDE may be covered under a patient's medical or pharmacy benefit (sometimes both). This coverage may be through Medicare, Medicaid, commercial insurance, or ADAP.
Benefit coverage
The benefit verification process will confirm how the patient's insurance plan covers APRETUDE, as well as whether it requires a prior authorization. You can begin the benefit verification process for your patient on the ViiVConnect.com Provider Portal.
You can also find a helpful PDF that explains how to read the Summary of Benefits Report and a checklist for managing benefit verification independently on ViiVConnect.com.
ADAP=AIDS Drug Assistance Program.
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Assigning an Administration Site
In-office administration
Administering APRETUDE in your office may allow you to reconnect every 2 months on patients’ sexual history, check on their current health, and monitor their adherence to medication, among other advantages.
ViiVConnect services and support offer a number of helpful, downloadable resources for administering APRETUDE, including an APRETUDE Prescription Flow Overview, guides on subjects such as APRETUDE acquisition and ordering, and checklists for specialty pharmacy and Buy and Bill acquisition options. For more downloads and support, visit ViiVConnect.com.ASAs
Some HCPs prefer to send patients to an ASA, which handles the acquisition and administration of APRETUDE, as well as other services.
The ViiV network ASAs provide defined services for APRETUDE to support patient adherence. These services include:
- Benefit verification
- Coordination of prior authorizations
- Navigation of ViiVConnect and Patient Savings Program
- Clinician-led onboarding call for patients
- Regular communication with your office
- Multiple patient appointment reminders
The ViiV ASA Locator Tool may also include non-network ASAs that have indicated that they can administer APRETUDE at their locations. However, their service offerings may be different than those listed for ViiV Network ASAs.
The ASA Locator Tool may help you and your patient find an ASA.
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Acquiring APRETUDE
Use an Alternative Site for Administration (ASA)
The ASA both acquires and administers APRETUDE. Locate an ASA>
How ViiVConnect can help
Services available include:
- Benefit verification and annual reverification
- Prior authorization, claim denials, and appeals support
- Specialty pharmacy support and appointment reminders for patients
Contact ViiVConnect
Call 1-844-588-3288 (toll-free) Monday-Friday, 8 AM-11 PM ET. Multilingual options available.