24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree]

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viloxazine

RxCUI: 2536554

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.
0.3%
Plan Coverage
16
Plans Covering
T3.3
Avg Tier
33.3%
Prior Auth Required

What the CMS Formulary Data Shows for 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree]

Per the CMS 2026 Part D formulary file, 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] (RxNorm concept RXCUI 2536554, generic name viloxazine) appears on 3 distinct formulary files spanning 16 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.3.

Real-world access to 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] depends on utilization management as much as tier placement: 33.3% of covering formularies require prior authorization. 66.7% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,252 Part D beneficiaries filled 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] in 2023, with total plan-and-beneficiary spending of $4,086,858 and an average per-beneficiary annual cost of $1,814.77. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] today.

Coverage Details

Formularies covering
3
Plans covering
16
Coverage rate
0.3%
Tier range
Tier 2 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
33.3% of formularies
Step therapy required
66.7% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
2,252
Total spending
$4,086,858
Avg per beneficiary
$1,814.77

Tier Distribution Across Plans

1 plans
Tier 2, Generic
15 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree]

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

Plan Insurer Tier PA Premium States
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T2 Yes $0 CA
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 No $0 NV
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T4 No $0 MS

Frequently Asked Questions

Is 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] covered by Medicare Part D?

Yes, 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] is covered by 16 Medicare Part D plans (0.3% of all Part D formularies).

What tier is 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] on Medicare Part D plans?

24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] averages Tier 3.3 across Part D plans, ranging from Tier 2 to Tier 4.

Does 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] require prior authorization?

33.3% of Part D formularies require prior authorization for 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree]. Step therapy: 66.7%. Quantity limits: 100%.

How much does Medicare spend on 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree]?

In 2023, total Medicare Part D spending on 24 HR viloxazine 100 MG Extended Release Oral Capsule [Qelbree] was $4,086,858, covering 2,252 beneficiaries. The average spend per beneficiary was $1,814.77.

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