Medicare Part D coverage · 0.6 · RxCUI 727542
0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] is covered by 1,356 Medicare Part D plans (26.8% of enrollable products), averaging Tier 4.5, with prior authorization required on 88.4% of covering formularies.
- 26.8%
- Plan coverage
- 1,356
- Plans covering
- T4.5
- Avg tier
- 88.4%
- Prior auth required
What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] (RxNorm concept RXCUI 727542, generic name 0.6) appears on 69 distinct formulary files spanning 1,356 Medicare Part D plan offerings - 26.8% 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 4.5.
Real-world access to 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] depends on utilization management as much as tier placement: 88.4% of covering formularies require prior authorization. 0% require step therapy. 20.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,671 Part D beneficiaries filled 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] in 2023, with total plan-and-beneficiary spending of $41,507,763 and an average per-beneficiary annual cost of $24,840.07. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] today.
Coverage Details
- Formularies covering
- 69
- Plans covering
- 1,356
- Coverage rate
- 26.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 88.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 20.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,671
- Total spending
- $41,507,763
- Avg per beneficiary
- $24,840.07
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]
95 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | Yes | $4.80 | TX |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | Yes | $15.20 | IL |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
Show the next 30 plans
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | Yes | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | Yes | $0 | FL |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] covered by Medicare Part D?
Yes, 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] is covered by 1,356 Medicare Part D plans (26.8% of all Part D formularies).
What tier is 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] on Medicare Part D plans?
0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] require prior authorization?
88.4% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]. Step therapy: 0%. Quantity limits: 20.3%.
How much does Medicare spend on 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]?
In 2023, total Medicare Part D spending on 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta] was $41,507,763, covering 1,671 beneficiaries. The average spend per beneficiary was $24,840.07.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 3 ML apomorphine hydrochloride 10 MG/ML Cartridge T4.5
- revefenacin 0.0583 MG/ML Inhalation Solution [Yupelri] T4.5
- {56 (mitapivat 20 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG 4-Week] T4.5
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] T4.5
- {28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 60 MG Oral Tablet [Jynarque]) } Pack [Jynarque 60/30 Carton] T4.5
- {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] T4.5
Similar prior-authorization rate
- 1.56 ML abaloparatide 2 MG/ML Pen Injector [Tymlos] 88.5% PA
- 24 HR amantadine 137 MG Extended Release Oral Capsule [Gocovri] 88.2% PA
- 1 ML infliximab-dyyb 120 MG/ML Pen Injector [Zymfentra] 88% PA
- posaconazole 40 MG/ML Oral Suspension 88% PA
- tetrabenazine 12.5 MG Oral Tablet 87.8% PA
- tetrabenazine 25 MG Oral Tablet 87.8% PA