Canton, Mass., December 31, 2024 – Harvard Pilgrim Health Care regularly reviews our prescription medication coverage in order to offer a pharmacy benefit that is clinically appropriate and cost effective. Effective January 1, 2025, Harvard Pilgrim will cover eight initial HIV treatment regimens under the Core Maine, Core New Hampshire, and Core Rhode Island Formularies. The following treatment regimens will be available on these formularies:

DrugComplete Initial HIV Treatment Regimen
BiktarvyYes
DovatoYes
SymtuzaYes
TivicayIn combination with Truvada or Descovy1
DelstrigoYes
OdefseyYes
TriumeqYes
PrezcobixIn combination with abacavir & lamivudine

 

Brand Prezista has moved to non-formulary for all Harvard Pilgrim formularies because a generic is available.

For Maine and Rhode Island members, this change aligns with your 2024 Value Formulary coverage, with updated cost sharing and tiering for 2025. Members currently taking the impacted drugs will be notified in writing of this change.

Footnote(s)
1

Descovy covered with PA