| Human immunodeficiency virus I infection
Descovy for PrEP vs Symtuza
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Descovy vs Symtuza 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 signalsSymtuza has a higher rate of injection site reactions vs Descovy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Symtuza but not Descovy, including UnitedHealthcare
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Category
Descovy
Symtuza
At A Glance
Oral
Daily
NRTI combination
Oral
Once daily
Protease inhibitor + CYP3A inhibitor + NRTI combination
Indications
- Human immunodeficiency virus I infection
- Human immunodeficiency virus I infection
Dosing
Human immunodeficiency virus I infection Adults and pediatric patients >=35 kg: one 200 mg/25 mg tablet once daily with or without food; pediatric patients 25 to <35 kg: one 200 mg/25 mg tablet once daily; 14 to <25 kg: one 120 mg/15 mg tablet once daily (with other antiretrovirals including DRV+COBI but not other PI/ritonavir or PI/cobicistat combinations); not recommended with eGFR 15-30 mL/min or <15 mL/min without chronic hemodialysis.
HIV-1 PrEP One 200 mg/25 mg tablet once daily orally with or without food in adults and adolescents >=35 kg with eGFR >=30 mL/min, or adults with eGFR <15 mL/min on chronic hemodialysis (dose after hemodialysis); not recommended with eGFR 15-30 mL/min or <15 mL/min without hemodialysis.
Human immunodeficiency virus I infection One tablet orally once daily with food in adults and pediatric patients weighing at least 40 kg (800 mg darunavir/150 mg cobicistat/200 mg emtricitabine/10 mg tenofovir alafenamide).
Contraindications
- Unknown or positive HIV-1 status when used for HIV-1 PrEP
- Alfuzosin co-administration
- Carbamazepine, phenobarbital, or phenytoin co-administration
- Colchicine in patients with renal and/or hepatic impairment
- Rifampin co-administration
- Lurasidone or pimozide co-administration
- Dronedarone, ivabradine, or ranolazine co-administration
- Ergot derivatives (dihydroergotamine, ergotamine, methylergonovine) co-administration
- St. John's wort co-administration
- Elbasvir/grazoprevir co-administration
- Lomitapide, lovastatin, or simvastatin co-administration
- Naloxegol co-administration
- Sildenafil when used for pulmonary arterial hypertension
- Orally administered midazolam or triazolam co-administration
Adverse Reactions
Most common (>=10%) Nausea (in antiretroviral treatment-naive adults with HIV-1 receiving FTC+TAF with EVG+COBI)
Serious Severe acute exacerbations of hepatitis B, immune reconstitution syndrome, new onset or worsening renal impairment, lactic acidosis/severe hepatomegaly with steatosis
Postmarketing Angioedema, urticaria, rash, acute renal failure, acute tubular necrosis, proximal renal tubulopathy, Fanconi syndrome
Most common (>=2%) Diarrhea, rash, nausea, fatigue, headache, abdominal discomfort, flatulence
Serious Severe acute exacerbations of hepatitis B, hepatotoxicity, severe skin reactions, immune reconstitution syndrome, new onset or worsening renal impairment, lactic acidosis/severe hepatomegaly with steatosis
Postmarketing Redistribution of body fat, rhabdomyolysis, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, acute renal failure, acute tubular necrosis, proximal renal tubulopathy, Fanconi syndrome, crystal nephropathy, crystalluria
Pharmacology
Dual HIV NRTI combination; emtricitabine (FTC) and tenofovir alafenamide (TAF) each inhibit HIV-1 reverse transcriptase via nucleotide analog chain termination after intracellular phosphorylation, with TAF serving as a prodrug converted intracellularly to tenofovir and then to the active metabolite tenofovir diphosphate.
Symtuza is a fixed-dose combination containing darunavir (an HIV-1 protease inhibitor that prevents cleavage of Gag-Pol polyproteins), cobicistat (a CYP3A inhibitor that enhances darunavir exposure), emtricitabine (an NRTI that inhibits HIV reverse transcriptase through chain termination), and tenofovir alafenamide (an NRTI prodrug converted to tenofovir diphosphate that inhibits HIV reverse transcriptase).
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Most Common Insurance
Anthem BCBS
Descovy
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (1/12) · Qty limit (11/12)
Symtuza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Descovy
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Symtuza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Descovy
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Symtuza
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
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
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.