Ibalizumab-uiyk (Trogarzo)

Covered: ibalizumab (Trogarzo) for adults (≥18) with HIV‑1 who are heavily treatment‑experienced and failing current antiretroviral therapy with documented multidrug resistance (resistance to ≥1 drug in ≥3 ARV classes) when used with an optimized background regimen and prescribed/consulted by an HIV specialist; excluded are patients <18, those not failing therapy, without documented multidrug resistance, or use as monotherapy/off‑label. Key requirements: initial approval 6 months (reauthorization 12 months) with evidence of virologic response (e.g., ≥0.5 log10 HIV RNA reduction) for continuation, IV dosing 2000 mg load then 800 mg q2w, and documentation of age, HIV infection, treatment failure/history, resistance testing, background regimen, specialist order/consult, and viral load for reauthorization.

"Trogarzo, in combination with other antiretroviral(s), is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in heavily treatment-experienced adults with multidrug..."