3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn]
apomorphine hydrochloride
RxCUI: 855858
What the CMS Formulary Data Shows for 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn]
Per the CMS 2026 Part D formulary file, 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] (RxNorm concept RXCUI 855858, generic name apomorphine hydrochloride) appears on 4 distinct formulary files spanning 30 Medicare Part D plan offerings - 0.6% 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 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] depends on utilization management as much as tier placement: 25% of covering formularies require prior authorization. 0% require step therapy. 25% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 581 Part D beneficiaries filled 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] in 2023, with total plan-and-beneficiary spending of $71,778,607 and an average per-beneficiary annual cost of $123,543.21. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 30
- Coverage rate
- 0.6%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 25% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 25% of formularies
2023 Medicare Spending
- Beneficiaries
- 581
- Total spending
- $71,778,607
- Avg per beneficiary
- $123,543.21
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn]
30 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Presbyterian Senior Care Plan 3 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $65.80 | NM |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T6 | No | $0 | PR |
Frequently Asked Questions
Is 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] covered by Medicare Part D?
Yes, 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] is covered by 30 Medicare Part D plans (0.6% of all Part D formularies).
What tier is 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] on Medicare Part D plans?
3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] require prior authorization?
25% of Part D formularies require prior authorization for 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn]. Step therapy: 0%. Quantity limits: 25%.
How much does Medicare spend on 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn]?
In 2023, total Medicare Part D spending on 3 ML apomorphine hydrochloride 10 MG/ML Cartridge [Apokyn] was $71,778,607, covering 581 beneficiaries. The average spend per beneficiary was $123,543.21.
Read our methodology - how this data is sourced, computed, and verified.