How Much Does Biktarvy Cost With Medicare?
Biktarvy (Bictegravir/Emtricitabine/TAF) costs an average of $3,746 per Medicare Part D claim, with total Medicare spending of $3821.0M in the latest year. No generic alternative is currently available.
Key Facts: Biktarvy Cost
- Medicare Part D avg
- $3,746/claim
- Likely Part D tier
- Tier 4-5 (specialty)
- Annual cost/patient
- $44,953
- Generic available
- No
- Manufacturer
- Gilead
- Treats
- HIV
- Patent expires
- 2033-02-07
- YoY price change
- +12.8%
Source: CMS Medicare Part D Spending Dashboard. Tier placement inferred from typical formulary norms — confirm with your specific Part D plan.
Biktarvy Medicare Coverage & Out-of-Pocket Cost
Biktarvy is covered under Medicare Part D, with the program paying an average of $3,746 per prescription fill. Biktarvy typically falls on Tier 4-5 (specialty) of standard Part D formularies. Specialty drugs use coinsurance (25-33% of plan-negotiated price), not flat copays. The 2025 Part D annual out-of-pocket cap is $2,000.
Your actual out-of-pocket cost depends on three factors: (1) formulary tier — your plan's specific placement; (2) deductible status — most plans require you to meet up to a $590 deductible (2025) before copays kick in; (3) coverage phase — initial coverage, then the donut hole was eliminated in 2025, replaced by a hard $2,000 annual out-of-pocket cap under the Inflation Reduction Act. Once you hit $2,000 in true out-of-pocket spending, the rest of your Part D drugs are free for the year.
No generic is currently available for Biktarvy. Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute prohibits them for federal program enrollees), but charity foundations such as the PAN Foundation, NeedyMeds, and the HealthWell Foundation offer copay grants for many hiv drugs. The Medicare Extra Help (LIS) program also reduces Part D costs to near-zero for income-qualified beneficiaries (under 150% of the federal poverty level).
For cash-pay or commercial insurance scenarios, compare prices using GoodRx, SingleCare, or Cost Plus Drugs before filling — discount-program prices sometimes beat Part D copays for lower-cost generics.
Biktarvy is manufactured by Gilead and prescribed primarily for HIV. In the most recent Medicare Part D data, 1,020,000 claims were filed for 85,000 unique beneficiaries, at an average cost of $3,746 per claim. Average annual cost per beneficiary is $44,953.
Year over year, Medicare spending on Biktarvy has increased by +12.8%. No generic substitute is available, so the brand-name price reflects the full market cost. Its patent expires 2033-02-07.
Biktarvy belongs to the HIV Antiretrovirals class. Modern HIV treatment uses 2-3 drugs combined in one pill. Integrase strand transfer inhibitors (INSTIs like bictegravir in Biktarvy) block HIV from inserting its genetic material into human cells. NRTIs (tenofovir, emtricitabine) block the virus from copying its RNA into DNA. The combination prevents resistance. Once-daily single-tablet regimens achieve >95% viral suppression.
Key Data
| Metric | Value |
|---|---|
| Avg Cost Per Claim | $3,746 |
| Total Medicare Spending | $3821.0M |
| Total Claims | 1,020,000 |
| Beneficiaries | 85,000 |
| Generic Available | No |
| Year-Over-Year Change | +12.8% |
Other Drugs for HIV
Frequently Asked Questions
Medicare Part D pays an average of $3,746 per claim for Biktarvy. Biktarvy is typically placed on Tier 4-5 (specialty) of standard Part D formularies. Specialty drugs use coinsurance (25-33% of plan-negotiated price), not flat copays. The 2025 Part D annual out-of-pocket cap is $2,000. As of 2025, total annual out-of-pocket on Part D is capped at $2,000 under the Inflation Reduction Act.
Yes. Biktarvy appears in Medicare Part D claims data, with 85,000 beneficiaries filling 1,020,000 prescriptions in the latest year. Specific coverage depends on your plan's formulary — call the number on your insurance card or check the plan's Summary of Benefits to confirm prior authorization, step therapy, or quantity limit requirements.
Biktarvy (Bictegravir/Emtricitabine/TAF) costs an average of $3,746 per Medicare Part D claim, with total Medicare spending of $3821.0M in the latest year. No generic alternative is currently available.
No. As of the latest FDA Orange Book data, there is no generic version of Biktarvy (Bictegravir/Emtricitabine/TAF). Patent protection extends until 2033-02-07, after which generics may enter the market.
Medicare beneficiaries cannot use manufacturer copay cards (anti-kickback statute), but several options exist: (1) Apply to charity copay foundations like the PAN Foundation, NeedyMeds, HealthWell Foundation, or Patient Advocate Foundation — many cover hiv drugs; (2) Ask your prescriber about therapeutic alternatives in the same drug class that may be on a lower tier; (3) For some drugs, paying cash via GoodRx or Cost Plus Drugs can beat your Medicare copay — always compare before filling; (4) If your income is below 150% of the federal poverty level, you may qualify for the Medicare Extra Help (Low-Income Subsidy) program, which reduces Part D costs to near-zero.
Biktarvy is manufactured by Gilead. The FDA application number is NDA210251.
Biktarvy (Bictegravir/Emtricitabine/TAF) is primarily prescribed for HIV.
Medicare Part D spending on Biktarvy has increased +12.8% year over year. Total program spending reached $3821.0M in the latest reporting year.
Biktarvy (Bictegravir/Emtricitabine/TAF) costs an average of $3,746 per Medicare Part D claim, with total Medicare spending of $3821.0M in the latest year. No generic alternative is currently available.
This answer pulls from CMS Medicare Part D Drug Spending data, the authoritative federal source for U.S. Medicare prescription-drug pricing. The headline number above is the direct answer; what follows is the additional context most readers need to use the answer for a real decision rather than just a fact lookup.
A practical caveat: the headline answer above reflects the most recent CMS Medicare Part D Drug Spending data vintage; underlying data is often revised for months after first publication, and the right reference for any specific decision is whichever vintage is current at the time of the decision. The as-of date is stamped on every page.
Source: CMS Medicare Part D Spending, 2026.