0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe
adalimumab-fkjp
RxCUI: 2640412
What the CMS Formulary Data Shows for 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2640412, generic name adalimumab-fkjp) appears on 12 distinct formulary files spanning 16 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.5.
Real-world access to 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 91.7% of covering formularies require prior authorization. 0% require step therapy. 91.7% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 16
- Coverage rate
- 0.3%
- Tier range
- Tier 1 – Tier 3
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 91.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 91.7% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe
16 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T3 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | TROY HEALTH, INC. | T3 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH | T3 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T3 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T3 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T3 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T3 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T3 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T3 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T3 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T3 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T3 | Yes | $0 | MI |
Frequently Asked Questions
Is 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe covered by Medicare Part D?
Yes, 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe is covered by 16 Medicare Part D plans (0.3% of all Part D formularies).
What tier is 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe on Medicare Part D plans?
0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 3.
Does 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe require prior authorization?
91.7% of Part D formularies require prior authorization for 0.4 ML adalimumab-fkjp 50 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 91.7%.
Read our methodology - how this data is sourced, computed, and verified.