Medicare Part D coverage · {28 · RxCUI 2598465
{28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]
Per the CMS 2026 Part D formulary file, {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] is covered by 306 Medicare Part D plans (6.1% of enrollable products), averaging Tier 4.3, with prior authorization required on 92.3% of covering formularies.
- 6.1%
- Plan coverage
- 306
- Plans covering
- T4.3
- Avg tier
- 92.3%
- Prior auth required
What the CMS Formulary Data Shows for {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]
Per the CMS 2026 Part D formulary file, {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] (RxNorm concept RXCUI 2598465, generic name {28) appears on 39 distinct formulary files spanning 306 Medicare Part D plan offerings - 6.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.3.
Real-world access to {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] depends on utilization management as much as tier placement: 92.3% 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 31 Part D beneficiaries filled {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] in 2023, with total plan-and-beneficiary spending of $5,958,633 and an average per-beneficiary annual cost of $192,213.98. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] today.
Coverage Details
- Formularies covering
- 39
- Plans covering
- 306
- Coverage rate
- 6.1%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 92.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 76.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 31
- Total spending
- $5,958,633
- Avg per beneficiary
- $192,213.98
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]
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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $31.20 | DE |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
Show the next 30 plans
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Complete Blue HMO Distinct (HMO) | Highmark Choice Company | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Merit (PPO) | Highmark Senior Solutions Company | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Bcbsd Inc. | T5 | Yes | $0 | DE |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] covered by Medicare Part D?
Yes, {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] is covered by 306 Medicare Part D plans (6.1% of all Part D formularies).
What tier is {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] on Medicare Part D plans?
{28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] require prior authorization?
92.3% of Part D formularies require prior authorization for {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]. Step therapy: 0%. Quantity limits: 76.9%.
How much does Medicare spend on {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]?
In 2023, total Medicare Part D spending on {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] was $5,958,633, covering 31 beneficiaries. The average spend per beneficiary was $192,213.98.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] T4.3
- omadacycline 100 MG Injection [Nuzyra] T4.3
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] T4.3
- deflazacort 22.75 MG/ML Oral Suspension T4.3
- 0.5 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif] T4.3
Similar prior-authorization rate
- glutamine 5000 MG Powder for Oral Solution [Endari] 92.3% PA
- givinostat 8.86 MG/ML Oral Suspension [Duvyzat] 92.3% PA
- tretinoin 0.5 MG/ML Topical Cream 92.1% PA
- Abuse-Deterrent 24 HR hydrocodone bitartrate 20 MG Extended Release Oral Tablet 92.1% PA
- Abuse-Deterrent 24 HR hydrocodone bitartrate 100 MG Extended Release Oral Tablet 92.1% PA
- Pediatric 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] 92.5% PA