1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx]
bimekizumab-bkzx
RxCUI: 2668103
What the CMS Formulary Data Shows for 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx]
Per the CMS 2026 Part D formulary file, 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] (RxNorm concept RXCUI 2668103, generic name bimekizumab-bkzx) appears on 66 distinct formulary files spanning 1,403 Medicare Part D plan offerings - 27.7% 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 4.2.
Real-world access to 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] depends on utilization management as much as tier placement: 98.5% of covering formularies require prior authorization. 0% require step therapy. 90.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 13 Part D beneficiaries filled 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] in 2023, with total plan-and-beneficiary spending of $299,437 and an average per-beneficiary annual cost of $23,033.58. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] today.
Coverage Details
- Formularies covering
- 66
- Plans covering
- 1,403
- Coverage rate
- 27.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 90.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 13
- Total spending
- $299,437
- Avg per beneficiary
- $23,033.58
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | HEALTH CHOICE ARIZONA, INC. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | HEALTHFIRST HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | ITASCA MEDICAL CARE | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | HOPKINS HEALTH ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | Yes | $0 | MA |
| CCA One Care (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | ELDERPLAN, INC. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO) | AETNA HEALTH INC.(GA) | T5 | Yes | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T5 | Yes | $0 | WI |
Frequently Asked Questions
Is 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] covered by Medicare Part D?
Yes, 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] is covered by 1,403 Medicare Part D plans (27.7% of all Part D formularies).
What tier is 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] on Medicare Part D plans?
1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] require prior authorization?
98.5% of Part D formularies require prior authorization for 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx]. Step therapy: 0%. Quantity limits: 90.9%.
How much does Medicare spend on 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx]?
In 2023, total Medicare Part D spending on 1 ML bimekizumab-bkzx 160 MG/ML Auto-Injector [Bimzelx] was $299,437, covering 13 beneficiaries. The average spend per beneficiary was $23,033.58.
Read our methodology - how this data is sourced, computed, and verified.