Resources to support patient access

*Subject to eligibility and program terms and conditions. The ViiVConnect Copay Program does not constitute health insurance. Restrictions apply.

Acquisition options
J Code J0741

The acquisition pathway is determined by the payer as outlined in the patient's summary of benefits.

  • Pharmacy Benefit: Specialty Pharmacy Acquisition

    If your patient's insurance covers CABENUVA under the pharmacy benefit, you may acquire CABENUVA through a specialty pharmacy (SP).

    How it works

    1. Submit the prescription
    2. The SP submits the claim for CABENUVA and collects the copay
        • Remind your patient to answer the call from the SP
    3. SP will ship CABENUVA
        • Your office will coordinate the shipment with the SP in advance of the patient's injection appointment
    4. Schedule the patient's appointment and administer the injections
        • Reschedule subsequent injection appointments
    5. Collect copay from the patient, if applicable
        • For the office visit and administration

  • Medical Benefit: Buy-and-Bill Acquisition

    If your patient's insurance covers CABENUVA under the medical benefit, you may acquire CABENUVA through a specialty distributor, also known as Buy and Bill.

    How it works

    1. Order CABENUVA from a specialty distributor
    2. Schedule the patient's appointment and administer the injection
        • Pull CABENUVA from inventory and administer to the patient
        • Schedule subsequent injections
    3. Bill for reimbursement
        • Your office will bill the patient's insurance for product reimbursement and administration services as well as collect copays and coinsurance for the product

  • Medical Benefit: Assignment of Benefits (AOB)

    In some instances, a specialty pharmacy may be able to bill the patient's medical benefit, also referred to as an AOB. An AOB is a secondary process used by a payer that will help determine if CABENUVA can be sourced through a specialty pharmacy while covered under a medical benefit. The process varies widely by payer and, depending on your patient's coverage, is not always an option.

    Speak with our field reimbursement team to learn more about acquiring CABENUVA through the medical benefit.

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