Cabenuva is ViiV Healthcare’s long-acting injectable HIV treatment, a pairing of cabotegravir and rilpivirine given as two intramuscular shots in the buttock either monthly or every two months. It replaces a daily pill for people who are already virally suppressed.
Pricing it is harder than pricing a pill, for one structural reason: Cabenuva is usually a medical-benefit drug rather than a pharmacy-benefit drug. The clinic buys it, injects it, and bills your medical insurance, which means the drug charge and the injection charge arrive as two different line items and neither one behaves like a prescription copay. This guide separates those two costs using federal benchmark data current as of September 2026, then walks through the assistance programs that make the sticker price mostly theoretical.
What Does Cabenuva Cost Without Insurance?
There is no published cash retail price for Cabenuva because it is not sold at a retail counter. The closest public benchmark is the Medicare Part B payment limit, which CMS sets at the average sales price plus 6 percent and republishes every quarter. The figures below use the July 2026 Medicare Part B Payment Limit File, effective July 1 through September 30, 2026, which prices HCPCS code J0741 (cabotegravir and rilpivirine) at $24.667 per 2 mg / 3 mg billing unit.
| Cost component | Low | Typical | High |
|---|---|---|---|
| Monthly maintenance injection, 400 mg / 600 mg (drug only) | $4,933.40 | $4,933.40 | $5,229.40 (Medicare allowed, ASP + 6%) |
| Initiation or every-2-month injection, 600 mg / 900 mg (drug only) | $7,400.10 | $7,400.10 | $7,844.11 (Medicare allowed, ASP + 6%) |
| Injection administration, per visit (two injections) | $26.84 (Medicare allowed) | $110.66 (average charge submitted) | Clinic sets its own self-pay rate |
| Full year, every-2-month schedule (6 injections) | $44,400.60 | $44,400.60 | $51,800.70 (first year, 7 injections) |
| Full year, monthly schedule (12 injections) | $59,200.80 | $59,200.80 | $61,667.50 (first year) |
| What most insured patients actually pay per dose | $0 | Under $10 | Varies by plan |
A second federal dataset lines up with those numbers. CMS’s Medicare Part B Spending by Drug file shows Cabenuva at $21.04 average spending per dosage unit across 2024, with an average of $5,471.25 per claim and $20,847.21 per beneficiary that year. Per-claim spending sitting between the monthly and every-two-month dose values is exactly what you would expect from a mixed population, and the per-unit price rising from $18.38 in 2021 to $21.04 in 2024 shows a drug whose price drifts up a few percent a year.
The last row is the one that matters most for a real person. ViiV’s own patient page reports that after coverage and assistance options, most people pay $0 per dose, and that 9 out of 10 people pay less than $10 out of pocket per dose, based on specialty pharmacy data from December 2024 through November 2025. ViiV also notes on the same page that additional costs may be incurred for product administration, which is the clinic fee, not the drug.
The Injection Schedule Decides Your Annual Cost
Cabenuva’s FDA label allows two schedules, and they cost meaningfully different amounts because the drug is priced per milligram.
On the monthly schedule, you get one initiation injection of 600 mg cabotegravir and 900 mg rilpivirine, then 400 mg / 600 mg every month after that. That is 4,800 mg of cabotegravir a year and roughly $59,201 in drug cost at steady state.
On the every-two-month schedule, you get 600 mg / 900 mg injections one month apart for two consecutive months, then the same 600 mg / 900 mg dose every two months starting at month four. That is 3,600 mg a year, six injections, and roughly $44,401 at steady state, about 25 percent less drug cost than monthly dosing plus half as many clinic visits and half as many administration fees.
The label also allows an optional oral lead-in of about one month, using daily cabotegravir and rilpivirine tablets before the first injection. If your clinician uses one, that is a separate pharmacy-benefit prescription with its own price on top of everything above.
What Drives the Price
It is billed to your medical benefit, not your pharmacy benefit. This is the single most consequential fact about Cabenuva’s cost. ViiV tells patients to check both benefits and to bring both cards to the appointment, precisely because coverage can land on either side. A drug that runs through the medical benefit is subject to your deductible and coinsurance rather than a flat drug copay, which is how a $4,933 injection turns into a four-figure patient bill on a high-deductible plan.
The clinic charges separately for the shot. Cabenuva is two injections at every visit, so the administration is billed twice under CPT 96372. In CMS’s 2024 national physician data, the average charge submitted for one 96372 in an office setting was $55.33 and the average Medicare allowed amount was $13.42. Two injections a visit puts the typical submitted charge near $111 and the Medicare allowed amount near $27. A self-pay clinic sets its own number, and it may also bill a nursing or office visit on top.
Where you get injected changes the bill. ViiV promotes Alternative Sites of Care, meaning a facility other than your regular clinic that administers the injections. Site of service is a real cost variable in medical-benefit billing, and a hospital outpatient department will generally charge more for the same injection than a physician office.
Dose strength, not frequency, sets the drug price. Because J0741 is billed per 2 mg / 3 mg unit, a 600 mg / 900 mg injection is exactly 1.5 times the price of a 400 mg / 600 mg one. There is no volume discount and no package price.
Cash Price vs. Insurance
For Cabenuva, there is effectively no cash market. No pharmacy posts a retail price, no discount card touches it, and paying out of pocket for a buy-and-bill specialty injection is not a realistic path for almost anyone. The practical question is not “what is the cash price” but “which assistance program covers me.”
Commercial insurance. The ViiVConnect Copay Program can bring the copay to as little as $0 per injection, and unusually, eligible patients may also get help with out-of-pocket costs associated with administration. Your provider submits the explanation of benefits for both the copay and the administration fee. Manufacturer copay programs exclude anyone on Medicare, Medicaid or another government plan.
No insurance. The ViiV Healthcare Patient Assistance Program, operated by the GSK Patient Access Programs Foundation, provides ViiV medicines at no cost to patients who qualify. Its posted criteria: you live in the 50 states, DC or Puerto Rico, you are uninsured, you meet financial income criteria, you are not enrolled in ADAP, and you are not on Medicaid or another federal or state health plan except Medicare. Medicare Part A, B, D and Medicare Advantage enrollees can qualify if they meet the other requirements.
ADAP and Ryan White. Every state and territory runs an AIDS Drug Assistance Program under Ryan White Part B, which provides FDA-approved medications to low-income people with HIV who have limited or no insurance. Each state sets its own financial eligibility, usually as a percentage of the federal poverty level, and each state sets its own formulary. That last part matters: ADAPs must cover at least one drug from each class of antiretroviral, but whether your state’s formulary includes Cabenuva specifically is a state-by-state question worth asking before you start.
Cabenuva vs. a Daily Pill
The honest comparison is with a single-tablet oral regimen. Biktarvy, the most-prescribed one, costs pharmacies $136.73 per tablet in the CMS acquisition file effective August 19, 2026, which is about $4,102 for a 30-day supply and roughly $49,224 a year. Our Biktarvy cost guide breaks down the discounts and assistance on that side.
Set against it, Cabenuva every two months is about $44,401 a year in drug cost, slightly less than the pill, while Cabenuva monthly is about $59,201, about 20 percent more. Add the administration fees and six to twelve clinic visits a year that the pill does not require, and the every-two-month injection roughly ties the pill while the monthly injection costs meaningfully more.
If you are weighing the injectable route for prevention rather than treatment, the same every-two-month schedule and the same administration fee apply to Apretude, the long-acting injectable form of PrEP.
None of this is a treatment recommendation. Adherence, privacy, side effects and resistance history drive that decision, and only your clinician can weigh them. The cost point is narrow: if the injection is right for you, the every-two-month schedule is the cheaper version of it, and it is worth asking whether you are eligible.
How to Pay Less
- Enroll in ViiVConnect before your first injection, not after. Call 1-844-588-3288. Enrollment routes you into the copay program, the patient assistance program or a benefits investigation depending on your coverage, and it is easier to set up before a bill exists than to unwind one afterward.
- Apply to your state ADAP if you are uninsured or underinsured. It is a separate program from the manufacturer’s and it can also help pay insurance premiums for eligible clients. Note that ViiV’s assistance program and ADAP are mutually exclusive, so pick the one you qualify for.
- Ask about the every-two-month schedule. Six injections a year instead of twelve is half the administration fees, half the visits, and about 25 percent less drug cost.
- Verify both benefits before the first shot. Ask the clinic to run a benefits check on the pharmacy side and the medical side, and ask specifically what your deductible and coinsurance do to a medical-benefit drug. This is where surprise bills come from.
- Ask what the administration fee will be, in dollars, in advance. It is a separate line item and clinics set it themselves. Our fair price tool shows what common services cost in cash so you can tell a normal charge from an inflated one.
- If a bill still lands, work it. A specialty injection billed to the medical benefit is exactly the kind of charge that gets appealed or reduced. Start with our guides to negotiating a medical bill and to hospital charity care, which many hospital-affiliated infusion and injection clinics are required to offer.
The Bottom Line
Cabenuva’s list-level price is $4,933.40 per monthly injection and $7,400.10 per initiation or every-two-month injection at the federal benchmark in effect for September 2026, which is $44,401 to $59,201 a year in drug cost before the clinic’s injection charge of roughly $27 to $111 per visit.
Those numbers describe the invoice, not the patient. Between the ViiVConnect copay program, ViiV’s patient assistance program and state ADAPs, ViiV reports 9 out of 10 patients pay under $10 per dose. The work is in the paperwork, not the price, and it is worth doing before the first injection rather than after the first bill.