Medicare Part D coverage · 1 · RxCUI 2589384
1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]
Per the CMS 2026 Part D formulary file, 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] is covered by 376 Medicare Part D plans (7.4% of enrollable products), averaging Tier 4.1, with prior authorization required on 98.1% of covering formularies.
- 7.4%
- Plan coverage
- 376
- Plans covering
- T4.1
- Avg tier
- 98.1%
- Prior auth required
What the CMS Formulary Data Shows for 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]
Per the CMS 2026 Part D formulary file, 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] (RxNorm concept RXCUI 2589384, generic name 1) appears on 54 distinct formulary files spanning 376 Medicare Part D plan offerings - 7.4% 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 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] depends on utilization management as much as tier placement: 98.1% of covering formularies require prior authorization. 0% require step therapy. 92.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,712 Part D beneficiaries filled 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] in 2023, with total plan-and-beneficiary spending of $31,579,580 and an average per-beneficiary annual cost of $18,446.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] today.
Coverage Details
- Formularies covering
- 54
- Plans covering
- 376
- Coverage rate
- 7.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 92.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,712
- Total spending
- $31,579,580
- Avg per beneficiary
- $18,446.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | Yes | $15.20 | IL |
Show the next 30 plans
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | Yes | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF North Carolina, Inc. | T1 | Yes | $36.20 | NC |
| 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 |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $40.00 | NJ |
| 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 |
| ElderServe Star (HMO I-SNP) | Elderserve Health, Inc. | T1 | Yes | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF NEW York, Inc. | T1 | Yes | $58.80 | 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 |
| The Health Plan SecureCare - Option II (HMO) | THE Health Plan OF West Virginia, Inc. | T5 | Yes | $0 | OH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] covered by Medicare Part D?
Yes, 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] is covered by 376 Medicare Part D plans (7.4% of all Part D formularies).
What tier is 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] on Medicare Part D plans?
1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] require prior authorization?
98.1% of Part D formularies require prior authorization for 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]. Step therapy: 0%. Quantity limits: 92.6%.
How much does Medicare spend on 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]?
In 2023, total Medicare Part D spending on 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] was $31,579,580, covering 1,712 beneficiaries. The average spend per beneficiary was $18,446.02.
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
- {52 (trospium chloride 20 MG / xanomeline 100 MG Oral Capsule [Cobenfy]) / 4 (trospium chloride 20 MG / xanomeline 50 MG Oral Capsule [Cobenfy]) } Pack [Cobenfy 28-Day Starter Kit] T4.1
- flutamide 125 MG Oral Capsule [Eulexin] T4.1
- iloperidone 10 MG Oral Tablet [Fanapt] T4.1
- lumateperone 42 MG Oral Capsule [Caplyta] T4.1
- trospium chloride 30 MG / xanomeline 125 MG Oral Capsule [Cobenfy] T4.1
- avatrombopag 10 MG Oral Granules [Doptelet] T4.1
Similar prior-authorization rate
- atogepant 10 MG Oral Tablet [Qulipta] 98.1% PA
- alanine 21.7 MG/ML / arginine 14.7 MG/ML / aspartate 4.34 MG/ML / glutamate 7.49 MG/ML / glycine 10.4 MG/ML / histidine 8.94 MG/ML / isoleucine 7.49 MG/ML / leucine 10.4 MG/ML / lysine 11.8 MG/ML / methionine 7.49 MG/ML / phenylalanine 10.4 MG/ML / proline 8.94 MG/ML / serine 5.92 MG/ML / threonine 7.49 MG/ML / tryptophan 2.5 MG/ML / tyrosine 0.39 MG/ML / valine 9.6 MG/ML Injectable Solution [Plenamine] 98.1% PA
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.24 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 1.4 MG/ML / lysine 1.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / sodium acetate 0.097 MEQ/ML / sodium chloride 0.003 MEQ/ML / sodium metabisulfite 0.5 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.84 MG/ML / valine 7.8 MG/ML Injectable Solution [Trophamine 10 %] 98.1% PA
- {56 (mitapivat 20 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG 4-Week] 98.1% PA
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] 98.1% PA
- 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] 98.1% PA