1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin]

Verify with CMS →

corticotropin

RxCUI: 2707578

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
4.8%
Plan Coverage
241
Plans Covering
T4.2
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin]

Per the CMS 2026 Part D formulary file, 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] (RxNorm concept RXCUI 2707578, generic name corticotropin) appears on 38 distinct formulary files spanning 241 Medicare Part D plan offerings - 4.8% 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 4.2.

Real-world access to 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 34.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 326 Part D beneficiaries filled 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] in 2023, with total plan-and-beneficiary spending of $70,772,429 and an average per-beneficiary annual cost of $217,093.34. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] today.

Coverage Details

Formularies covering
38
Plans covering
241
Coverage rate
4.8%
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
34.2% of formularies

2023 Medicare Spending

Beneficiaries
326
Total spending
$70,772,429
Avg per beneficiary
$217,093.34

Tier Distribution Across Plans

14 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
7 plans
Tier 4, Non-Preferred
78 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
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
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 Yes $4.80 FL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 Yes $17.00 AZ
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T4 Yes $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T4 Yes $0 NY
Leon MediExtra (HMO) LEON HEALTH, INC. T4 Yes $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T4 Yes $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T4 Yes $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T4 Yes $0 FL
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T4 Yes $51.60 NY
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T5 Yes $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T5 Yes $0 NY
Troy Medicare (HMO) TROY HEALTH, INC. T5 Yes $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) TROY HEALTH, INC. T5 Yes $0 NC
Contra Costa Health Care Plus (HMO D-SNP) CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH T5 Yes $0 CA
SummaCare Medicare Topaz (HMO) SUMMACARE INC. T5 Yes $0 OH
SummaCare Medicare Quartz (HMO) SUMMACARE INC. T5 Yes $0 OH
Keystone First VIP Choice (HMO D-SNP) VISTA HEALTH PLAN, INC. T5 Yes $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) VISTA HEALTH PLAN, INC. T5 Yes $0 PA
First Choice VIP Care (HMO D-SNP) SELECT HEALTH OF SOUTH CAROLINA, INC. T5 Yes $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T5 Yes $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T5 Yes $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS FLORIDA INC T5 Yes $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS LOUISIANA, INC. T5 Yes $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS NORTH CAROLINA, INC. T5 Yes $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH MICHIGAN, INC. T5 Yes $0 MI
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T5 Yes $0 FL
Gold Heart & Diabetes Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T5 Yes $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T5 Yes $0 FL
Gold Health (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T5 Yes $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T5 Yes $0 FL
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T5 Yes $0 AZ

Frequently Asked Questions

Is 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] covered by Medicare Part D?

Yes, 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] is covered by 241 Medicare Part D plans (4.8% of all Part D formularies).

What tier is 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] on Medicare Part D plans?

1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] require prior authorization?

100% of Part D formularies require prior authorization for 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin]. Step therapy: 0%. Quantity limits: 34.2%.

How much does Medicare spend on 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin]?

In 2023, total Medicare Part D spending on 1 ML corticotropin 80 UNT/ML Prefilled Syringe [Cortrophin] was $70,772,429, covering 326 beneficiaries. The average spend per beneficiary was $217,093.34.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial