0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio]
vedolizumab
RxCUI: 2667342
What the CMS Formulary Data Shows for 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio]
Per the CMS 2026 Part D formulary file, 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] (RxNorm concept RXCUI 2667342, generic name vedolizumab) appears on 65 distinct formulary files spanning 462 Medicare Part D plan offerings - 9.1% 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 4.6.
Real-world access to 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] depends on utilization management as much as tier placement: 98.5% of covering formularies require prior authorization. 0% require step therapy. 90.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,238 Part D beneficiaries filled 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] in 2023, with total plan-and-beneficiary spending of $99,999,923 and an average per-beneficiary annual cost of $44,682.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] today.
Coverage Details
- Formularies covering
- 65
- Plans covering
- 462
- Coverage rate
- 9.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 98.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 90.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,238
- Total spending
- $99,999,923
- Avg per beneficiary
- $44,682.72
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| 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 |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | Yes | $5.00 | OK |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| 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 |
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| Blue Medicare Essential Plus (HMO-POS) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Blue Medicare Choice (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Blue Medicare Essential (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Experience Health Medicare Advantage (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Healthy Blue + Medicare (HMO-POS D-SNP) | BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH | T5 | Yes | $0 | NC |
| Blue Advantage Choice (PPO) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | T5 | Yes | $0 | AL |
| Blue Advantage Plus (PPO) | PATRIUS HEALTH, INC. | T5 | Yes | $0 | MS |
| Blue Advantage Capital (PPO) | PATRIUS HEALTH, INC. | T5 | Yes | $0 | MS |
| Blue Advantage Magnolia (PPO) | PATRIUS HEALTH, INC. | T5 | Yes | $0 | MS |
| Blue Advantage Complete (PPO) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | T5 | Yes | $0 | AL |
| EmblemHealth VIP Value (HMO-POS) | HEALTH INSURANCE PLAN OF GREATER NEW YORK | T5 | Yes | $0 | NY |
| EmblemHealth VIP Dual Reserve (HMO D-SNP) | HEALTH INSURANCE PLAN OF GREATER NEW YORK | T5 | Yes | $0 | NY |
| EmblemHealth VIP Dual (HMO D-SNP) | HEALTH INSURANCE PLAN OF GREATER NEW YORK | T5 | Yes | $0 | NY |
| EmblemHealth VIP Dual Enhanced (HMO D-SNP) | HEALTH INSURANCE PLAN OF GREATER NEW YORK | T5 | Yes | $0 | NY |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
Frequently Asked Questions
Is 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] covered by Medicare Part D?
Yes, 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] is covered by 462 Medicare Part D plans (9.1% of all Part D formularies).
What tier is 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] on Medicare Part D plans?
0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] averages Tier 4.6 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] require prior authorization?
98.5% of Part D formularies require prior authorization for 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio]. Step therapy: 0%. Quantity limits: 90.8%.
How much does Medicare spend on 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio]?
In 2023, total Medicare Part D spending on 0.68 ML vedolizumab 159 MG/ML Auto-Injector [Entyvio] was $99,999,923, covering 2,238 beneficiaries. The average spend per beneficiary was $44,682.72.
Read our methodology - how this data is sourced, computed, and verified.