| HIV Infections
Biktarvy vs Cabenuva
Side-by-side clinical, coverage, and cost comparison for hiv infections.Deep comparison between: Biktarvy vs Cabenuva with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsCabenuva has a higher rate of injection site reactions vs Biktarvy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Cabenuva but not Biktarvy, including UnitedHealthcare
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Category
Biktarvy
Cabenuva
At A Glance
Oral
Daily
INSTI + NRTI combination
IM injection (gluteal)
Every 4 weeks or every 8 weeks
INSTI + NNRTI combination
Indications
- HIV Infections
- HIV Infections
Dosing
HIV Infections - adults and pediatric >= 25 kg One tablet (50 mg BIC/200 mg FTC/25 mg TAF) taken orally once daily with or without food; on hemodialysis days, administer after hemodialysis completion.
HIV Infections - pediatric 14 kg to < 25 kg One tablet (30 mg BIC/120 mg FTC/15 mg TAF) taken orally once daily with or without food.
HIV Infections - virologically-suppressed pregnant individuals One tablet (50 mg BIC/200 mg FTC/25 mg TAF) taken orally once daily with or without food; monitor viral load closely due to lower drug exposures during pregnancy.
HIV Infections (Monthly Dosing) Initiation: cabotegravir 600 mg IM + rilpivirine 900 mg IM on last day of current antiretroviral therapy or oral lead-in; Continuation: cabotegravir 400 mg IM + rilpivirine 600 mg IM every month thereafter. Separate gluteal injection sites required.
HIV Infections (Every 2-Month Dosing) Initiation: cabotegravir 600 mg IM + rilpivirine 900 mg IM on last day of current antiretroviral therapy or oral lead-in, repeated 1 month later; Continuation: cabotegravir 600 mg IM + rilpivirine 900 mg IM every 2 months thereafter. Separate gluteal injection sites required.
Contraindications
- Co-administration with dofetilide due to potential for increased dofetilide plasma concentrations and serious or life-threatening events
- Co-administration with rifampin due to substantially decreased BIC plasma concentrations, which may result in loss of therapeutic effect and development of resistance
- Previous hypersensitivity reaction to cabotegravir or rilpivirine
- Carbamazepine, oxcarbazepine, phenobarbital, phenytoin (anticonvulsants)
- Rifabutin, rifampin, rifapentine (antimycobacterials)
- Dexamethasone (systemic, more than single dose)
- St. John's wort (Hypericum perforatum)
Adverse Reactions
Most common (>=5%) Diarrhea, nausea, headache
Serious Severe acute exacerbations of hepatitis B, immune reconstitution syndrome, new onset or worsening renal impairment, lactic acidosis/severe hepatomegaly with steatosis
Postmarketing Acute renal failure, acute tubular necrosis, proximal renal tubulopathy, Fanconi syndrome, angioedema, Stevens-Johnson syndrome/toxic epidermal necrolysis, urticaria, weight increased
Most common (>=2%) Injection site reactions (pain/discomfort, nodules, induration, swelling, erythema, pruritus, bruising/discoloration, warmth, hematoma), pyrexia, fatigue, headache, musculoskeletal pain, nausea, sleep disorders, dizziness, rash
Serious Hypersensitivity reactions including angioedema and urticaria, hepatotoxicity, depression and suicidal ideation/attempt, severe skin reactions including DRESS and Stevens-Johnson syndrome/toxic epidermal necrolysis
Postmarketing Hypersensitivity reactions, nephrotic syndrome, severe skin and hypersensitivity reactions including DRESS, Stevens-Johnson syndrome, toxic epidermal necrolysis
Pharmacology
BIKTARVY is a fixed-dose combination antiretroviral containing bictegravir (BIC), an integrase strand transfer inhibitor (INSTI) that blocks integration of HIV-1 DNA into host genomic DNA, plus emtricitabine (FTC) and tenofovir alafenamide (TAF), both nucleoside analog reverse transcriptase inhibitors (NRTIs) that terminate viral DNA chain elongation by competing with natural nucleoside substrates.
Cabotegravir inhibits HIV integrase by binding to the active site and blocking the strand transfer step essential for HIV replication. Rilpivirine is an NNRTI that inhibits HIV-1 replication by non-competitive inhibition of HIV-1 reverse transcriptase.
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Most Common Insurance
Anthem BCBS
Biktarvy
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (11/12)
Cabenuva
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Biktarvy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Cabenuva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Biktarvy
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Cabenuva
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0
Gilead Advancing Access Patient Assistance Program/Medication Assistance Program (PAP/MAP)Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0/fillfill
Cabenuva Patient Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.