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Is Descovy covered by insurance? | How much does Descovy cost without insurance? | How to get Descovy without insurance
Descovy is a brand-name prescription drug prescribed to control or prevent HIV-1 infections, the virus that causes HIV/AIDS. Descovy combines two antiviral drugs, emtricitabine and tenofovir alafenamide, that prevent the HIV-1 virus from producing new virus particles. Adults and adolescents prescribed Descovy will take a daily 200/25 mg tablet, but children weighing less than 55 pounds will take a smaller daily dose of 120/15 mg. Descovy is an expensive brand-name drug. It has no generic alternatives, but that does not mean that it is out of reach. Several strategies can significantly cut the cost to as low as $0.
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Is Descovy covered by insurance?
Most commercial health insurance or Medicaid plans cover the cost of Descovy, particularly if it is prescribed to prevent HIV infection. Descovy is usually covered by Medicare Part D plans.
How much does Descovy cost without insurance?
Paying the full retail price for Descovy will average $2,465 per month. That will purchase 30 tablets, so people paying cash price will spend about $82 per tablet. For both HIV treatment and prevention, Descovy is a long-term treatment, so an entire year’s worth of Descovy could cost almost $30,000 for the uninsured.
Of course, health insurance helps. While the out-of-pocket cost will depend on a plan’s formulary, deductible, and coinsurance, people with commercial health insurance pay an average of $0 to $45 per month. A copay savings card from Gilead Sciences can reduce that cost to as low as $0. People with Medicare coverage for Descovy pay an average of $0 to $9 per month. Medicaid costs average from $4 to $9 per month. However, if Descovy is prescribed for pre-exposure prophylaxis (PreP), commercial health insurance plans and Medicaid expansion plans must pay the full cost of the prescription. The cost to the patient will be $0.
People without insurance will not be able to substitute a cheaper generic version of Descovy. Keep in mind that there are two drugs in Descovy: emtricitabine and tenofovir alafenamide. They are both nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). NRTIs are the foundation of HIV/AIDS treatment. They prevent HIV from replicating by putting “bad parts” into the virus’s genetic information. The Centers for Disease Control and Prevention (CDC) treatment guidelines specify that at least two NRTIs should always be used jointly for HIV prevention and treatment. Other FDA-approved combination NRTI drugs include Truvada (emtricitabine-tenofovir), Epzicom (abacavir-lamivudine), and Combivir (lamivudine-zidovudine). These can be purchased as lower-priced generics.
RELATED: Descovy vs. Truvada: Differences, similarities, and which is better for you
Compare Descovy prices to related drugs |
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|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Descovy (emtricitabine-tenofovir alafenamide) | $2,465 per 30, 200/25 mg tablets | $1,732 per 30, 200/25 mg tablets of brand-name Descovy | See updated prices |
| Combivir (lamivudine-zidovudine) | $978 per 60, 150/300 mg tablets | $70 per 60, 150/300 mg tablets of generic Combivir | See updated prices |
| Epzicom (abacavir-lamivudine) | $1,678 per 30, 600/300 mg tablets | $57 per 30, 600/300 mg tablets of generic Epzicom | See updated prices |
| Truvada (emtricitabine-tenofovir disoproxil fumarate) | $2,327 per 30, 200/300 mg tablets | $26 per 1, 30 tablet bottle of generic Truvada | See updated prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs. The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see updated drug prices.
How to get Descovy without insurance
Without health insurance coverage, financial assistance, or discounts, Descovy may be expensive over the long term. Uninsured patients can apply to Gilead’s patient assistance program, Gilead Advancing Access Program, but not everyone will be able to meet the eligibility requirements. However, people without coverage have options to make Descovy treatment more affordable. Some people may be able to get Descovy for free. Here are six options:
1. Use a SingleCare savings card
A SingleCare discount card can reduce the cost of a Descovy prescription by as much as $700, saving almost $8,500 per year. A free Descovy coupon can be found by either choosing the lowest discount price or a preferred SingleCare participating pharmacy.
2. Enroll with ADAP to get free or low-cost HIV/AIDS drugs
Uninsured and underinsured HIV/AIDS patients can enroll in the AIDS Drug Assistance Program (ADAP). Administered through the states using federal money, this medication assistance program will pay some or all of the cost of FDA-approved medications for HIV/AIDS and HIV/AIDS-related infections. Each state determines eligibility criteria and manages the enrollment process. If the program has run out of Descovy or some other needed drug, the HarborPath ADAP Waiting List program may have a supply donated by the manufacturer. The prescribing healthcare provider will need to help with enrollment.
3. Get private health insurance or Medicaid
Having health insurance coverage may ensure a much lower cost of HIV treatment. If Descovy is prescribed for HIV prevention (PreP) to HIV-negative patients, then most commercial health insurance plans and some Medicaid plans will pay all of the costs, including Descovy, doctor’s visits, lab tests, and other PreP medications.
4. Ask the prescribing healthcare provider for a free sample
It may take time to find an enduring way to afford Descovy, so ask the prescriber for a free sample. This may be enough free Descovy to cover a few weeks or a month.
5. Look for the lowest price
No matter what the medication is, shopping for a better price may help to save money. The lowest price for Descovy could be $600 lower than the highest price. Even better, shop for the lowest SingleCare price and save even more.
6. Get medical advice about switching to generic HIV/AIDS drugs
Descovy is a two-drug treatment regimen. At least three other two-drug medications combine the same types of drugs as Descovy, but they are available in less-expensive generic versions. With a SingleCare discount card, a 30-day supply of any of these generics can be purchased for less than $60.
