Cabotegravir and Rilpivirine (Cabenuva®)

Covered: Cabenuva is allowed as a complete ART regimen to replace current therapy for HIV‑1 patients ≥12 years and ≥35 kg who are virologically suppressed (HIV‑1 RNA <50 copies/mL) and have no history of treatment failure or known/suspected resistance; it is not covered for patients with RNA ≥50 copies/mL, prior treatment failure, or resistance. Key requirements: prior stable ARV ≥4 months (or one‑month Vocabria oral lead‑in), documented difficulty with daily oral ART or severe GI issues, prescription by/consultation with an HIV specialist, adherence to approved monthly or every‑2‑month injection dosing, 12‑month approval 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 their current antiretrovi..."