As several posts have illustrated, Aetna/CVS have excluded Vemlidy from the preferred medication for chronic HepB. The patient has 50,000 IU/mL DNA count with compensated cirrhosis, normal kidney and bone, moderate hypertension. Does it justify a pre-authorization for TAF? If not, is it safe to take TDF for a year and switch to TAF? Thank you.
Hello @Giovana,
I believe the decision on whether to apply for a prior authorization is up to the physician who is prescribing the medication. From the insurance company’s side, it’s probably unlikely to be approved if there’s no evidence of kidney disease or bone loss, especially if you haven’t already tried cheaper generic options such as TDF or entecavir. It is definitely safe to switch from TDF to TAF and vice versa. I started with TDF years ago and haven’t had issues, so I stuck with it because it’s cheaper. My insurance also doesn’t cover TAF, but I wasn’t too upset about it because I took TDF before TAF was even approved, and it worked well for me.
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Thank you for sharing your experience and insights.
Hi Giovana,
I wanted to share my experience since I, too, use Aetna/CVS. I started off treatment with TAF so when they wanted me to switch, I was quite upset since I felt like TAF was working so well for me and I didn’t want to deal with trying another drug which may have more side effects (kidney disease/bone loss). My doctor was able to appeal and justify my staying on TAF since I had showed some unexplained fluctuations in my LFTs in the past for no apparent reason. I finally stabalized, although they still remain mildly elevated and he didn’t want to disrupt my treatment by trying another drug. They complied and allowed me to stay on TAF but I have to request he write the appeal every year.
So my situation is a bit different but just wanted to share in case someone else is in the same circumstance.
Rebecca
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Thank you for sharing the information. Wish you the best 
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