Trogarzo® (Ibalizumab-Uiyk) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Trogarzo (ibalizumab‑uiyk) only for treatment of multi‑drug resistant HIV‑1 (not recommended as routine initial antiretroviral therapy per DHHS guidance) when strict criteria are met. Coverage requires provider attestation of multi‑drug resistance, use with an optimized background regimen containing at least one fully susceptible antiretroviral, dosing per FDA label, initial and continuation authorizations limited to ≤12 months, and for continuation prior Trogarzo use with documented clinically significant viral response; benefits remain subject to the member’s specific plan terms.

"Authorization for continuation therapy is for no more than 12 months"

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