{56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
tolvaptan
RxCUI: 2274816
What the CMS Formulary Data Shows for {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
Per the CMS 2026 Part D formulary file, {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] (RxNorm concept RXCUI 2274816, generic name tolvaptan) appears on 24 distinct formulary files spanning 1,197 Medicare Part D plan offerings - 23.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.6.
Real-world access to {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] depends on utilization management as much as tier placement: 91.7% of covering formularies require prior authorization. 0% require step therapy. 54.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 486 Part D beneficiaries filled {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] in 2023, with total plan-and-beneficiary spending of $76,164,444 and an average per-beneficiary annual cost of $156,716.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] today.
Coverage Details
- Formularies covering
- 24
- Plans covering
- 1,197
- Coverage rate
- 23.6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 91.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 54.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 486
- Total spending
- $76,164,444
- Avg per beneficiary
- $156,716.96
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
9 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
91 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Health First Rewards H1099-014 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $0 | FL |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T4 | Yes | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T4 | Yes | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T4 | Yes | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T4 | Yes | $0 | FL |
| Health First Value H1099-006 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | No | $15.00 | FL |
| Health First Classic H1099-001 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | No | $49.40 | FL |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MO |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MO |
| HealthSpring Premier (HMO-POS) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | UT |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | NM |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | OH |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred Savings (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | OH |
| HealthSpring Preferred Savings (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | CO |
| HealthSpring Preferred (HMO) | BRAVO HEALTH MID-ATLANTIC, INC. | T5 | Yes | $0 | DC, DE |
| HealthSpring Preferred PA (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | NJ |
Frequently Asked Questions
Is {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] covered by Medicare Part D?
Yes, {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] is covered by 1,197 Medicare Part D plans (23.6% of all Part D formularies).
What tier is {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] on Medicare Part D plans?
{56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] averages Tier 4.6 across Part D plans, ranging from Tier 1 to Tier 5.
Does {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] require prior authorization?
91.7% of Part D formularies require prior authorization for {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]. Step therapy: 0%. Quantity limits: 54.2%.
How much does Medicare spend on {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]?
In 2023, total Medicare Part D spending on {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] was $76,164,444, covering 486 beneficiaries. The average spend per beneficiary was $156,716.96.
Read our methodology - how this data is sourced, computed, and verified.