Medicare Part D coverage · 0.8 · RxCUI 2675315
0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza]
Per the CMS 2026 Part D formulary file, 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] is covered by 194 Medicare Part D plans (3.8% of enrollable products), averaging Tier 4.4, with prior authorization required on 100% of covering formularies.
- 3.8%
- Plan coverage
- 194
- Plans covering
- T4.4
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza]
Per the CMS 2026 Part D formulary file, 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] (RxNorm concept RXCUI 2675315, generic name 0.8) appears on 37 distinct formulary files spanning 194 Medicare Part D plan offerings - 3.8% 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 4.4.
Real-world access to 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 78.4% 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 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] today.
Coverage Details
- Formularies covering
- 37
- Plans covering
- 194
- Coverage rate
- 3.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 78.4% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
| 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 |
Show the next 30 plans
| PHP (HMO C-snp) | Aids Healthcare Foundation | T4 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T4 | Yes | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T4 | Yes | $51.60 | NY |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Complete Blue HMO Distinct (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Merit (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Bcbsd Inc. | T5 | Yes | $0 | DE |
| eternalHealth Forever (HMO) | Eternalhealth, Inc. | T5 | Yes | $0 | MA |
| eternalHealth Freedom (PPO) | Eternalhealth, Inc. | T5 | Yes | $0 | MA |
| eternalHealth Give Back (PPO) | Eternalhealth, Inc. | T5 | Yes | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] covered by Medicare Part D?
Yes, 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] is covered by 194 Medicare Part D plans (3.8% of all Part D formularies).
What tier is 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] on Medicare Part D plans?
0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza] require prior authorization?
100% of Part D formularies require prior authorization for 0.8 ML nedosiran 160 MG/ML Prefilled Syringe [Rivfloza]. Step therapy: 0%. Quantity limits: 78.4%.
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
- 0.5 ML filgrastim-sndz 0.6 MG/ML Prefilled Syringe [Zarxio] T4.4
- 168 HR granisetron 0.129 MG/HR Transdermal System [Sancuso] T4.4
- chenodeoxycholate 250 MG Oral Tablet [Ctexli] T4.4
- maralixibat 10 MG Oral Tablet [Livmarli] T4.4
- sucroferric oxyhydroxide 500 MG Chewable Tablet [Velphoro] T4.4
- 0.5 ML nedosiran 160 MG/ML Injection [Rivfloza] T4.4
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA