24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega]

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paliperidone

RxCUI: 686441

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.
0%
Plan Coverage
2
Plans Covering
T1
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega]

Per the CMS 2026 Part D formulary file, 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] (RxNorm concept RXCUI 686441, generic name paliperidone) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,964 Part D beneficiaries filled 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] in 2023, with total plan-and-beneficiary spending of $5,169,576 and an average per-beneficiary annual cost of $1,744.12. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

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

2023 Medicare Spending

Beneficiaries
2,964
Total spending
$5,169,576
Avg per beneficiary
$1,744.12

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY

Frequently Asked Questions

Is 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] covered by Medicare Part D?

Yes, 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] on Medicare Part D plans?

24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] require prior authorization?

100% of Part D formularies require prior authorization for 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega]?

In 2023, total Medicare Part D spending on 24 HR paliperidone 3 MG Extended Release Oral Tablet [Invega] was $5,169,576, covering 2,964 beneficiaries. The average spend per beneficiary was $1,744.12.

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