Medicare Part D coverage · {28 · RxCUI 2598470
{28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]
Per the CMS 2026 Part D formulary file, {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] is covered by 191 Medicare Part D plans (3.8% of enrollable products), averaging Tier 4.3, with prior authorization required on 97.3% of covering formularies.
- 3.8%
- Plan coverage
- 191
- Plans covering
- T4.3
- Avg tier
- 97.3%
- Prior auth required
What the CMS Formulary Data Shows for {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]
Per the CMS 2026 Part D formulary file, {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] (RxNorm concept RXCUI 2598470, generic name {28) appears on 37 distinct formulary files spanning 191 Medicare Part D plan offerings - 3.8% 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 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] depends on utilization management as much as tier placement: 97.3% of covering formularies require prior authorization. 0% require step therapy. 73% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 31 Part D beneficiaries filled {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 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 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] today.
Coverage Details
- Formularies covering
- 37
- Plans covering
- 191
- Coverage rate
- 3.8%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 97.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 73% 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 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 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 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] covered by Medicare Part D?
Yes, {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] is covered by 191 Medicare Part D plans (3.8% of all Part D formularies).
What tier is {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] on Medicare Part D plans?
{28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] require prior authorization?
97.3% of Part D formularies require prior authorization for {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]. Step therapy: 0%. Quantity limits: 73%.
How much does Medicare spend on {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]?
In 2023, total Medicare Part D spending on {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 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 epoetin alfa 40000 UNT/ML Injection [Procrit] T4.3
- epoetin alfa 20000 UNT/ML Injectable Solution [Procrit] T4.3
- 28 ACTUAT teriparatide 0.02 MG/ACTUAT Pen Injector [Bonsity] T4.3
- perampanel 4 MG Oral Tablet [FYCOMPA] T4.3
- caplacizumab-yhdp 11 MG Injection [Cablivi] T4.3
- caffeine 100 MG / ergotamine tartrate 2 MG Rectal Suppository [Migergot] T4.3
Similar prior-authorization rate
- rilonacept 220 MG Injection [Arcalyst] 97.3% PA
- glutamine 5000 MG Powder for Oral Solution 97.2% PA
- 0.5 ML ustekinumab-aekn 90 MG/ML Injection [Selarsdi] 97.4% PA
- alanine 21.7 MG/ML / arginine 14.7 MG/ML / aspartate 4.34 MG/ML / glutamate 7.49 MG/ML / glycine 10.4 MG/ML / histidine 8.94 MG/ML / isoleucine 7.49 MG/ML / leucine 10.4 MG/ML / lysine 11.8 MG/ML / methionine 7.49 MG/ML / phenylalanine 10.4 MG/ML / proline 8.94 MG/ML / serine 5.92 MG/ML / threonine 7.49 MG/ML / tryptophan 2.5 MG/ML / tyrosine 0.39 MG/ML / valine 9.6 MG/ML Injectable Solution [Clinisol 15] 97.4% PA
- C1 esterase inhibitor (human) 500 UNT Injection [Berinert] 97.4% PA
- leuprolide acetate 22.5 MG Injection [Lutrate] 97.5% PA