Medicare Part D coverage · {56 · RxCUI 2594795
{56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]
Per the CMS 2026 Part D formulary file, {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] is covered by 1,457 Medicare Part D plans (28.8% of enrollable products), averaging Tier 4.5, with prior authorization required on 98.1% of covering formularies.
- 28.8%
- Plan coverage
- 1,457
- Plans covering
- T4.5
- Avg tier
- 98.1%
- Prior auth required
What the CMS Formulary Data Shows for {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]
Per the CMS 2026 Part D formulary file, {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] (RxNorm concept RXCUI 2594795, generic name {56) appears on 105 distinct formulary files spanning 1,457 Medicare Part D plan offerings - 28.8% 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 4.5.
Real-world access to {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] depends on utilization management as much as tier placement: 98.1% of covering formularies require prior authorization. 0% require step therapy. 83.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 26 Part D beneficiaries filled {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] in 2023, with total plan-and-beneficiary spending of $4,466,375 and an average per-beneficiary annual cost of $171,783.67. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] today.
Coverage Details
- Formularies covering
- 105
- Plans covering
- 1,457
- Coverage rate
- 28.8%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 98.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 83.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 26
- Total spending
- $4,466,375
- Avg per beneficiary
- $171,783.67
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| 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 |
Show the next 30 plans
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | Yes | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | Yes | $5.00 | OK |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | Yes | $15.20 | IL |
| 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 |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | Yes | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | Yes | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | Yes | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | Yes | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | Yes | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T5 | Yes | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T5 | Yes | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T5 | Yes | $0 | NM |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] covered by Medicare Part D?
Yes, {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] is covered by 1,457 Medicare Part D plans (28.8% of all Part D formularies).
What tier is {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] on Medicare Part D plans?
{56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 6.
Does {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] require prior authorization?
98.1% of Part D formularies require prior authorization for {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]. Step therapy: 0%. Quantity limits: 83.8%.
How much does Medicare spend on {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week]?
In 2023, total Medicare Part D spending on {56 (mitapivat 50 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 50 MG 4-Week] was $4,466,375, covering 26 beneficiaries. The average spend per beneficiary was $171,783.67.
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
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] T4.5
- {28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 60 MG Oral Tablet [Jynarque]) } Pack [Jynarque 60/30 Carton] T4.5
- phenoxybenzamine hydrochloride 10 MG Oral Capsule T4.5
- deferiprone 100 MG/ML Oral Solution [Ferriprox] T4.5
- 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] T4.5
- 3 ML apomorphine hydrochloride 10 MG/ML Cartridge T4.5
Similar prior-authorization rate
- atogepant 10 MG Oral Tablet [Qulipta] 98.1% 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 [Plenamine] 98.1% PA
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.24 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 1.4 MG/ML / lysine 1.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / sodium acetate 0.097 MEQ/ML / sodium chloride 0.003 MEQ/ML / sodium metabisulfite 0.5 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.84 MG/ML / valine 7.8 MG/ML Injectable Solution [Trophamine 10 %] 98.1% PA
- 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] 98.1% PA
- 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] 98.1% PA
- 1 ML ustekinumab 90 MG/ML Prefilled Syringe 98.1% PA