1 ML alirocumab 150 MG/ML Auto-Injector [Praluent]
alirocumab
RxCUI: 1659161
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.
11.1%
Plan Coverage
563
Plans Covering
T2.9
Avg Tier
100%
Prior Auth Required
What the CMS Formulary Data Shows for 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent]
Per the CMS 2026 Part D formulary file, 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] (RxNorm concept RXCUI 1659161, generic name alirocumab) appears on 43 distinct formulary files spanning 563 Medicare Part D plan offerings - 11.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.
Real-world access to 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 76.7% 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 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] today.
Coverage Details
- Formularies covering
- 43
- Plans covering
- 563
- Coverage rate
- 11.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 76.7% of formularies
Tier Distribution Across Plans
30 plans
Tier 1, Preferred Generic
70 plans
Tier 3, Preferred Brand
Standalone Drug Plans (PDP) Covering 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Wellcare Simple (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T3 | Yes | No | $0 | CT |
| Wellcare Giveback (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T3 | Yes | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | Yes | $0 | MA |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | Yes | $4.80 | TX |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | Yes | $15.20 | IL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| 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 |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| 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 |
| Wellcare Simple (HMO-POS) | COORDINATED CARE OF WASHINGTON, INC. | T3 | Yes | $0 | WA |
| Wellcare Simple Open (PPO) | WELLCARE OF MISSISSIPPI, INC. | T3 | Yes | $0 | MS |
| Wellcare Simple Open (PPO) | WELLCARE OF GEORGIA, INC. | T3 | Yes | $0 | GA |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T3 | Yes | $0 | TX |
| Wellcare Simple Open (PPO) | WELLCARE HEALTH INSURANCE COMPANY OF AMERICA | T3 | Yes | $0 | AR |
| Wellcare Simple (HMO) | HEALTH NET OF ARIZONA, INC. | T3 | Yes | $0 | AZ |
| Wellcare Simple (HMO) | HEALTH NET OF ARIZONA, INC. | T3 | Yes | $0 | AZ |
| Wellcare Simple Value (HMO) | HEALTH NET OF ARIZONA, INC. | T3 | Yes | $0 | AZ |
| Wellcare Simple (HMO-POS) | HEALTH NET OF ARIZONA, INC. | T3 | Yes | $0 | NV |
| Wellcare Simple (HMO-POS) | HEALTH NET OF ARIZONA, INC. | T3 | Yes | $0 | NV |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T3 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | HEALTH NET OF CALIFORNIA, INC. | T3 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | HEALTH NET OF CALIFORNIA, INC. | T3 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T3 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T3 | Yes | $0 | CA |
| Wellcare Simple (HMO-POS) | BUCKEYE COMMUNITY HEALTH PLAN, INC. | T3 | Yes | $0 | OH |
| Wellcare Low Premium (HMO-POS) | WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | T3 | Yes | $0 | NJ |
Frequently Asked Questions
Is 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] covered by Medicare Part D?
Yes, 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] is covered by 563 Medicare Part D plans (11.1% of all Part D formularies).
What tier is 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] on Medicare Part D plans?
1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent] require prior authorization?
100% of Part D formularies require prior authorization for 1 ML alirocumab 150 MG/ML Auto-Injector [Praluent]. Step therapy: 0%. Quantity limits: 76.7%.
Read our methodology - how this data is sourced, computed, and verified.
Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial