{18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]

Verify with CMS →

oteseconazole

RxCUI: 2605803

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.
2.2%
Plan Coverage
109
Plans Covering
T4.2
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]

Per the CMS 2026 Part D formulary file, {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] (RxNorm concept RXCUI 2605803, generic name oteseconazole) appears on 13 distinct formulary files spanning 109 Medicare Part D plan offerings - 2.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 5, with a cross-plan average of Tier 4.2.

Real-world access to {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 76.9% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 71 Part D beneficiaries filled {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] in 2023, with total plan-and-beneficiary spending of $222,182 and an average per-beneficiary annual cost of $3,129.33. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] today.

Coverage Details

Formularies covering
13
Plans covering
109
Coverage rate
2.2%
Tier range
Tier 4 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
76.9% of formularies

2023 Medicare Spending

Beneficiaries
71
Total spending
$222,182
Avg per beneficiary
$3,129.33

Tier Distribution Across Plans

88 plans
Tier 4, Non-Preferred
12 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue Rx PDP Complete (PDP) HM HEALTH INSURANCE COMPANY T4 Yes No $164.80 -
Blue Rx PDP Plus (PDP) HM HEALTH INSURANCE COMPANY T4 Yes No $193.20 -

Medicare Advantage Plans (MA-PD) Covering {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]

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

Plan Insurer Tier PA Premium States
Community Blue Medicare HMO Signature (HMO) Highmark Western and Northeastern New York Inc. T4 Yes $0 NY
Community Blue Medicare HMO Merit (HMO) Highmark Western and Northeastern New York Inc. T4 Yes $0 NY
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue Plus PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Security Blue HMO-POS ValueRx (HMO-POS) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Together Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Community Blue Medicare HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Complete Blue HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T4 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T4 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T4 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T4 Yes $0 WV
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T4 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK BCBSD INC. T4 Yes $0 DE
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 Yes $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 Yes $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 Yes $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 Yes $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 Yes $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 Yes $0 NV
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T4 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T4 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T4 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T4 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T4 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) UPMC HEALTH NETWORK, INC. T4 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC HEALTH COVERAGE, INC. T4 Yes $0 PA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T4 Yes $0 MS
Senior Blue 652 (HMO) Highmark Western and Northeastern New York Inc. T4 Yes $0.40 NY
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $1.00 PA
UPMC for Life HMO Rx Choice (HMO) UPMC HEALTH PLAN, INC. T4 Yes $3.90 OH, PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 Yes $6.00 PA

Frequently Asked Questions

Is {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] covered by Medicare Part D?

Yes, {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] is covered by 109 Medicare Part D plans (2.2% of all Part D formularies).

What tier is {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] on Medicare Part D plans?

{18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] averages Tier 4.2 across Part D plans, ranging from Tier 4 to Tier 5.

Does {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] require prior authorization?

100% of Part D formularies require prior authorization for {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]. Step therapy: 0%. Quantity limits: 76.9%.

How much does Medicare spend on {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count]?

In 2023, total Medicare Part D spending on {18 (oteseconazole 150 MG Oral Capsule [Vivjoa]) } Pack [Vivjoa 18-Count] was $222,182, covering 71 beneficiaries. The average spend per beneficiary was $3,129.33.

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