Vemlidy no longer in formulary effective July for major prescription coverage

General Discussion
13

That is definitely fast. I would also like to know what your doctor wrote that got approved so fast. Thank you

14

Hi- Thanks so much for posting this. If possible, could you send an email to Catherine.Freeland@hepb.org ? My colleagues and I can try to help with this issue! Please reach out!

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15

Hi! Thank you for replying to this post. I will reach out to the email you provided . It’s unbelievable what is happening after all the publicity in 2019 to get it back on the formulary . I’m wondering what the justifications that all these big pharmaceutical providers have in denying coverage . Is this a common thing in your experience with brand name medications with no generics available?

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16

Do you have the online link to Chinese online pharmacies that sells Vemlidy? I need to explore that option too. Thanks in advance.

17

Hi Thomas! If to switch to TDF, what is the equivalent mg to Vemlidy 25mg? Is there any related science article? Thanks!

18

Hi @SeanL,

@availlant has a post about this: Possible side-effects from antiviral therapy - #95 by availlant

300mg TDF is the equivalent amount (though this can sometimes be reported as 245mg depending on how that company is calculating the mass of the active compound). Your pharmacist will know as it is quite a standard dose.

Thomas

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20

Not a medical expert here but from my general understanding, resistance with Entecavir is rare. Did you skip doses or have them at irregular timing?

21

@ThomasTu
I switched from Viread to Vemlidy a few years ago. If I switch back to Viread now, should I worry about drug resistance issue with Viread?

22

Hi @Tahlah,

In both, the active compound is tenofovir, so there should not be an issue with drug resistance if the antivirals are still working.

Thomas

24

Hi everyone, as CVS Caremark stopped the coverage for Vemlidy, I wonder what insurance / program in U.S is still covering it? I’d like to switch to that next year. Thanks!

25

Hi everyone, as you may know CVS Caremark stops covering Vemlidy (Tenogovir alafenamide 25mg) starting this year July. I am wondering if anyone knows any other insurance programs in U.S who still cover this medicine? Would love to switch my insurance plan for this next year.

Thank you!

26

Hi I am in the same boat as you but I wrote an appeal along with my doctor and I got CVS to cover my Vemlidy for another year. I don’t know what other insurance will cover Vemlidy. Can’t you ask HR and ask the insurance plan if they will cover Vemlidy? Just a thought.

27

Hi Tulipe,

Thank you for your response! May I know what insurance plan are you currently in? CVS Caremark is a pharmacy benefit manager and I assume you work with your doctor under a separate insurance network?

Thanks!

28

I am still with CVS Caremark as you. This is my only option. I had written an appeal letter along with my doctor. I am sure if you appealed to CVS they will still allow you to be on Vemlidy.

29

@Suwang88, @CFreeland, @chari.cohen: wondering if there has been any resolutions or movements regarding this significant change in the US?

TT

30

Hi all Thanks so much for bringing this up again. We are seeing this as a really big issue on the ground. I am so sorry to say!

Currently, the only update is that we are currently bringing this to the attention of several medical organizations to see if anyone is willing to come together on an official stance against this issue. We are also sharing the social media campaign soon. I will be sure to share that and any other updates we hear from the medical societies.

Catherine

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31

I heard from my doctor that they tried to appeal but got denied. CVS Caremark requires patients to try 3 alternatives and show the proof that they all don’t work well before they can give patients exceptions.

How do you get it through? Any special reasons you mentioned in the appeal letter?

32

You need to appeal along with your doctor to CVS again. I did not even try different medications. My friend also had the same issue with CVS and she got her approval after appeal again. Yes I was rejected the first time but then got approval the second time.

33

Thank you all for sharing your experiences on this important change. I encourage you to keep sharing so that such issues can gain more visibility and make it more likely that there will be a solution found.

Thomas

34

Hello @ThomasTu, me I was placed on Tenefovir disappointed fumarate with lamivudine in it. Is it okay now that I read here that lamivudine isn’t recommended due to resistance :person_gesturing_ok: