1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]
tralokinumab-ldrm
RxCUI: 2589384
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 tralokinumab-ldrm) appears on 55 distinct formulary files spanning 388 Medicare Part D plan offerings - 7.7% 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: 98.2% of covering formularies require prior authorization. 0% require step therapy. 92.7% 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
- 55
- Plans covering
- 388
- Coverage rate
- 7.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 92.7% 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 Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $0 | MD |
| 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 |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | Yes | $21.70 | NH |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $31.20 | MD |
| 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 |
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 388 Medicare Part D plans (7.7% 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?
98.2% of Part D formularies require prior authorization for 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry]. Step therapy: 0%. Quantity limits: 92.7%.
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.