{28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]
alpelisib
RxCUI: 2598470
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 alpelisib) appears on 37 distinct formulary files spanning 192 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
- 192
- 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 |
| 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 |
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 192 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.