Apr 1, 2010
I am currently on a regime of Sustiva and Combivir. My viral load is undetectable and CD4 count is around 600; however, triglyceride level has gone through the roof! My doctor has suggested that I switch to Isentress; but my insurance does not currently cover Isentress. What do you suggest as an alternative to Isentress that will assist in lowering my triglyceride level? Do you see insurance companies changing their policy and covering Isentress in the near furture?
| Response from Ms. Franzoi
Whether or not Isentress is covered under the pharmacy benefit in a health plan depends on the type of formulary the plan has. There are open formularies and closed ones. If a plan has an open formulary, it will typically cover most drugs but might require a higher copayment if the drug requested is not in the preferred formulary. A plan with a closed formulary will only pay for generics or their formulary brands. It all depends on the plan.
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