{10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack]
cladribine
RxCUI: 2122661
What the CMS Formulary Data Shows for {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack]
Per the CMS 2026 Part D formulary file, {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] (RxNorm concept RXCUI 2122661, generic name cladribine) appears on 68 distinct formulary files spanning 172 Medicare Part D plan offerings - 3.4% 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.
Real-world access to {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] depends on utilization management as much as tier placement: 94.1% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,130 Part D beneficiaries filled {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] in 2023, with total plan-and-beneficiary spending of $156,344,544 and an average per-beneficiary annual cost of $138,358.00. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] today.
Coverage Details
- Formularies covering
- 68
- Plans covering
- 172
- Coverage rate
- 3.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 94.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,130
- Total spending
- $156,344,544
- Avg per beneficiary
- $138,358.00
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack]
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 |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $58.80 | NY |
| 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 |
| 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 |
| CenCal CareConnect (HMO D-SNP) | SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA | T5 | Yes | $0 | CA |
| SummaCare Medicare Topaz (HMO) | SUMMACARE INC. | T5 | Yes | $0 | OH |
| SummaCare Medicare Quartz (HMO) | SUMMACARE INC. | T5 | Yes | $0 | OH |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T5 | Yes | $0 | CA |
| 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 |
| Astiva Health Savings Plan (HMO) | ASTIVA HEALTH, INC. | T5 | Yes | $0 | CA |
| Astiva Health C-SNP Deluxe (HMO C-SNP) | ASTIVA HEALTH, INC. | T5 | Yes | $0 | CA |
Frequently Asked Questions
Is {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] covered by Medicare Part D?
Yes, {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] is covered by 172 Medicare Part D plans (3.4% of all Part D formularies).
What tier is {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] on Medicare Part D plans?
{10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] require prior authorization?
94.1% of Part D formularies require prior authorization for {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack]?
In 2023, total Medicare Part D spending on {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] was $156,344,544, covering 1,130 beneficiaries. The average spend per beneficiary was $138,358.00.
Read our methodology - how this data is sourced, computed, and verified.