0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

Verify with CMS →

pegfilgrastim-fpgk

RxCUI: 2613769

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
1.2%
Plan Coverage
61
Plans Covering
T4.2
Avg Tier
90%
Prior Auth Required

What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] (RxNorm concept RXCUI 2613769, generic name pegfilgrastim-fpgk) appears on 10 distinct formulary files spanning 61 Medicare Part D plan offerings - 1.2% 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 4.2.

Real-world access to 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] depends on utilization management as much as tier placement: 90% of covering formularies require prior authorization. 0% require step therapy. 10% 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 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] today.

Coverage Details

Formularies covering
10
Plans covering
61
Coverage rate
1.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
90% of formularies
Step therapy required
0% of formularies
Quantity limits
10% of formularies

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
59 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

61 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
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
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
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
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC HEALTH COVERAGE, INC. T5 Yes $0 PA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T5 Yes $0 MS
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T5 Yes $0 OR
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
UPMC for Life HMO Rx Choice (HMO) UPMC HEALTH PLAN, INC. T5 Yes $3.90 OH, PA
UPMC for Life HMO Deductible Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $18.10 OH, PA
PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T5 Yes $19.00 ID
Network Health Cares (PPO D-SNP) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $21.10 WI
Geisinger Gold Value Rx (HMO) GEISINGER HEALTH PLAN T5 Yes $23.00 PA
UPMC for Life PPO Rx Choice (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $25.00 PA
PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T5 Yes $29.10 OR
UPMC for Life PPO High Deductible Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $33.00 PA
UPMC for Life HMO Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $33.70 OH, PA
Network Health PlusRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $38.60 WI

Frequently Asked Questions

Is 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] covered by Medicare Part D?

Yes, 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] is covered by 61 Medicare Part D plans (1.2% of all Part D formularies).

What tier is 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] on Medicare Part D plans?

0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] require prior authorization?

90% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]. Step therapy: 0%. Quantity limits: 10%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial