Cabotegravir and Rilpivirine (Cabenuva®)

Covered as a complete injectable regimen to replace a current antiretroviral regimen for adolescents (≥12 years) and adults (≥35 kg) who are virologically suppressed (HIV‑1 RNA <50 copies/mL) and have no history of treatment failure or known/suspected resistance to cabotegravir or rilpivirine (not covered for viremic patients or those with prior failure/resistance). Key requirements: documentation of age/weight and viral suppression, prior stable ARV ≥4 months or one‑month oral lead‑in with Vocabria, evidence of difficulty with daily oral therapy or severe GI intolerance, prescription by/consultation with an HIV specialist, 12‑month approvals with renewal contingent on continued viral suppression.

"Cabenuva is indicated as a complete regimen for the treatment of HIV-1 infection in adults and adolescents 12 years of age and older and weighing at least 35 kg to replace the current antiretrovira..."