0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
pegfilgrastim-pbbk
RxCUI: 2602787
What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] (RxNorm concept RXCUI 2602787, generic name pegfilgrastim-pbbk) appears on 17 distinct formulary files spanning 52 Medicare Part D plan offerings - 1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.1.
Real-world access to 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] depends on utilization management as much as tier placement: 94.1% of covering formularies require prior authorization. 0% require step therapy. 5.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 11 Part D beneficiaries filled 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] in 2023, with total plan-and-beneficiary spending of $81,033 and an average per-beneficiary annual cost of $7,366.67. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] today.
Coverage Details
- Formularies covering
- 17
- Plans covering
- 52
- Coverage rate
- 1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 94.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 5.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 11
- Total spending
- $81,033
- Avg per beneficiary
- $7,366.67
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
52 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T5 | Yes | $0 | MI |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T5 | Yes | $0 | MS |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | OR |
| PacificSource Dual Care Alliance (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $19.00 | ID |
| Geisinger Gold Value Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $23.00 | PA |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $29.10 | OR |
| Geisinger Gold Classic Complete Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $48.00 | PA |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T5 | Yes | $88.70 | OR |
| Geisinger Gold Classic Advantage Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $99.30 | PA |
Frequently Asked Questions
Is 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] covered by Medicare Part D?
Yes, 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] is covered by 52 Medicare Part D plans (1% of all Part D formularies).
What tier is 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] on Medicare Part D plans?
0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] require prior authorization?
94.1% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]. Step therapy: 0%. Quantity limits: 5.9%.
How much does Medicare spend on 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]?
In 2023, total Medicare Part D spending on 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] was $81,033, covering 11 beneficiaries. The average spend per beneficiary was $7,366.67.
Read our methodology - how this data is sourced, computed, and verified.