Sunlenca® (lenacapavir) Injection

Covered only for adults ≥18 with heavily treatment‑experienced, multidrug‑resistant HIV‑1 who are failing their current antiretroviral regimen (not covered for <18, as monotherapy, or for non–FDA‑approved indications). Key requirements: documentation of resistance to ≥2 agents in each of at least three antiretroviral classes, use with an optimized background regimen, prescription by or in consultation with an HIV specialist, initial approval for 6 months (maintenance dosing 927 mg SC every 26 weeks ±2 weeks) and 12‑month reauthorizations contingent on documented virologic response.

"Approval durations: initial authorization limited to 6 months; reauthorization limited to 12 months."

Sign up to see full coverage criteria, indications, and limitations.