ADAP Formulary

ADAP Formulary

The ADAP drug formulary is a listing of all medications that are covered by the program for all eligible clients, whether insured or uninsured. If a medication is not listed on the drug formulary, then the insurance or assistance program will not cover the medication costs.

Medications Covered by ADAP (PDF)

Lenacapavir Prior Authorization Form (PDF)

Trogarzo

Trogarzo (ibalizumab-uiyk) is a first-in-class CD4-directed post-attachment HIV-1 inhibitor for people living with HIV who have tried multiple HIV medications in the past and whose HIV has not been successfully treated with other currently available therapies. Trogarzo is administered intravenously once every 14 days by a medical professional and must be used in combination with an optimized background regimen containing one or more antiretrovirals with activity against the virus.

Trogarzo is available to a limited number of eligible ADAP clients through a prior authorization process sent to the department’s medical team, and access will be coordinated through Thera Technologies’ distribution network for ADAP clients.

Trogarzo Patient and Provider Information

Trogarzo Prior Authorization Form

Trogarzo Enrollment Form

Resources to Address Potential Barriers to Long-Acting Injectable Antiretroviral Therapy