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!
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!
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.
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!
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.
@Suwang88, @CFreeland, @chari.cohen: wondering if there has been any resolutions or movements regarding this significant change in the US?
TT
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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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?
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.
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
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 
Hi Vera,
The tenofovir will prevent viral replication and resistance should not be able form.
Thomas
Greetings everyone,
I received a email with an update from the Hepatitis B Foundation that CVS and Aetna will resume Vemlidy coverage again. I believe this change comes due to a strong push back they got from the hepatitis B community and organizations. Now their commercial plans will cover vemlidy. I wanted to share this update here so those impacted can start the process to get this important medicine again.
Thanks, Bansah1.
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When do Vemlidy patents expire in Europe and USA?
I am not sure exactly, but it was approved in the US in 2016 and 2017 in Europe. Some patents can be 10 years or longer, and can be renewed. But I am not exactly sure when that is for Vemlidy. Thanks, Bansah1.
Thanks for the update, @Bansah1! I think this is great news for people maintaining access to their medication.
Cheers,
Thomas
I wanna say 2031-2032 when lupin is able to produce generics
Hi my name is John and just got diagnosed with chronic hepatitis B in the US. I am just looking for the best way to figure out the best insurance for me that covers hep B medication. I apologize if there is a feed for this already. I contacted by insurance and had to go thruogh this long process where they looked up the price for each drug. Now I am wondering if there are cheaper plans for my drug and how I would find them. Thanks.
Hi @john,
I thought this might be the best thread to discuss this. I’m not sure about the insurance aspects in the US, but perhaps someone in this thread could share their experiences or others (@hope4us, @Suwang88).
TT
Insurance formularies change frequently and Vemlidy has been a hot button issue. Hepatitis B Foundation has been petitioning for insurances to keep it on formulary and recently CVS Caremark did put it back in.
BUT the good news is that generic baraclude and tenofovir (TDF, generic version of Viread) are much more affordable now and you DO NOT need to even have insurance to get them.
You do need a doctors prescription but you can use GoodRx.com, CostPlus Pharmacy (Mark Cuban’s pharmacy) or there are other nonprofit pharmacies to access great prices.
For example, Viread Prices, Coupons & Savings Tips - GoodRx can be about $20 a month if you go to Walmart, Costco or a grocery store pharmacy. (Don’t go to CVS or Walgreens, those are always more expensive).
At Costplus, you can get entecavir for about $28 Medications Details | Mark Cuban Cost Plus Drug Company (costplusdrugs.com), and Tenofovir is $15 for a month or $35 for 3 months Medications Details | Mark Cuban Cost Plus Drug Company (costplusdrugs.com)
So try your insurance and see how much it costs with them. If it’s more than any of these, just go outside of your insurance!
And remember, even if your pharmacy fills a prescription and you find out it’s too much when they ring you up, you can choose not to buy it. Just say no thanks and they will return it to the shelf.
Hope that helps!!
Su
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