1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]
sarilumab
RxCUI: 1923347
What the CMS Formulary Data Shows for 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]
Per the CMS 2026 Part D formulary file, 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] (RxNorm concept RXCUI 1923347, generic name sarilumab) appears on 28 distinct formulary files spanning 108 Medicare Part D plan offerings - 2.1% 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 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 85.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,167 Part D beneficiaries filled 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] in 2023, with total plan-and-beneficiary spending of $110,312,728 and an average per-beneficiary annual cost of $26,472.94. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] today.
Coverage Details
- Formularies covering
- 28
- Plans covering
- 108
- Coverage rate
- 2.1%
- 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
- 85.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,167
- Total spending
- $110,312,728
- Avg per beneficiary
- $26,472.94
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]
1 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Prescription Blue Select (PDP) | BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY | T5 | Yes | No | $78.40 | - |
Medicare Advantage Plans (MA-PD) Covering 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]
99 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 |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| 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 |
| 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 |
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Fallon Medicare Plus Orange (HMO) | FALLON COMMUNITY HEALTH PLAN | T5 | Yes | $0 | MA |
| UPMC for Life HMO Premier Rx (HMO) | UPMC HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC HEALTH COVERAGE, INC. | T5 | Yes | $0 | PA |
| 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 |
| 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 |
| Health First Rewards H1099-014 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| FHCP Medicare Classic (HMO) | FLORIDA BLUE MEDICARE, INC. | T5 | Yes | $0 | FL |
Frequently Asked Questions
Is 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] covered by Medicare Part D?
Yes, 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] is covered by 108 Medicare Part D plans (2.1% of all Part D formularies).
What tier is 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] on Medicare Part D plans?
1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] require prior authorization?
100% of Part D formularies require prior authorization for 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]. Step therapy: 0%. Quantity limits: 85.7%.
How much does Medicare spend on 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara]?
In 2023, total Medicare Part D spending on 1.14 ML sarilumab 175 MG/ML Prefilled Syringe [Kevzara] was $110,312,728, covering 4,167 beneficiaries. The average spend per beneficiary was $26,472.94.
Read our methodology - how this data is sourced, computed, and verified.