abiraterone acetate 250 MG Oral Tablet [Abirtega]

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abiraterone acetate

RxCUI: 2702601

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
91.9%
Plan Coverage
4,655
Plans Covering
T2.9
Avg Tier
85.2%
Prior Auth Required

What the CMS Formulary Data Shows for abiraterone acetate 250 MG Oral Tablet [Abirtega]

Per the CMS 2026 Part D formulary file, abiraterone acetate 250 MG Oral Tablet [Abirtega] (RxNorm concept RXCUI 2702601, generic name abiraterone acetate) appears on 310 distinct formulary files spanning 4,655 Medicare Part D plan offerings - 91.9% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.

Real-world access to abiraterone acetate 250 MG Oral Tablet [Abirtega] depends on utilization management as much as tier placement: 85.2% of covering formularies require prior authorization. 0% require step therapy. 86.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 45,661 Part D beneficiaries filled abiraterone acetate 250 MG Oral Tablet [Abirtega] in 2023, with total plan-and-beneficiary spending of $877,469,517 and an average per-beneficiary annual cost of $19,217.05. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry abiraterone acetate 250 MG Oral Tablet [Abirtega] today.

Coverage Details

Formularies covering
310
Plans covering
4,655
Coverage rate
91.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
85.2% of formularies
Step therapy required
0% of formularies
Quantity limits
86.5% of formularies

2023 Medicare Spending

Beneficiaries
45,661
Total spending
$877,469,517
Avg per beneficiary
$19,217.05

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering abiraterone acetate 250 MG Oral Tablet [Abirtega]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 Yes $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
KeyCare Advantage Plus (HMO C-SNP) ISNP VENTURES, LLC T1 No $0 MD
Premier Care (HMO-POS I-SNP) LIFEWORKS ADVANTAGE, LLC T1 No $0 VA
Premier Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $0 CA
Advantage Care (HMO) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $0 CA
Premier Care (HMO-POS I-SNP) ALIGN SENIOR CARE MI, LLC T1 No $0 MI
Premier Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $0 FL
Perennial Advantage Freedom (HMO-POS) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 CO
Perennial Advantage Premier (HMO-POS I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 CO
Perennial Advantage Freedom (HMO) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 PA
Perennial Advantage Premier (HMO I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $0 PA
Perennial Advantage Freedom (HMO-POS) PERENNIAL ADVANTAGE OF OHIO, INC. T1 No $0 OH
Perennial Advantage Premier (HMO-POS I-SNP) PERENNIAL ADVANTAGE OF OHIO, INC. T1 No $0 OH
ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $0 TX
PruittHealth Premier Advantage (HMO I-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Senior Health Plan Silver Plus (HMO) COMMUNITYCARE GOVERNMENT PROGRAMS, INC. T1 No $0 OK
Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) COMMUNITYCARE GOVERNMENT PROGRAMS, INC. T1 No $0 OK
Community First Medicare Advantage Alamo Plan (HMO) COMMUNITY FIRST HEALTH PLANS, INC. T1 No $0 TX
Community First Medicare Advantage D-SNP (HMO D-SNP) COMMUNITY FIRST HEALTH PLANS, INC. T1 No $0 TX
Community DualCare Aligned (HMO D-SNP) COMMUNITY HEALTH CHOICE TEXAS, INC. T1 No $0 TX
Community DualCare Access (HMO D-SNP) COMMUNITY HEALTH CHOICE TEXAS, INC. T1 No $0 TX
El Paso Health Medicare Advantage Dual (HMO D-SNP) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
El Paso Health Total (HMO) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
El Paso Health Giveback (HMO) EL PASO FIRST HEALTH PLANS, INC. T1 No $0 TX
Liberty Medicare Advantage (HMO C-SNP) LIBERTY ADVANTAGE, LLC T1 No $0 NC
Peak Advantage Vista (PPO) PEAK HEALTH INSURANCE CORPORATION T1 No $0 PA, WV
SECUR Edge (HMO I-SNP) SECUR INC T1 No $0 FL
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA

Frequently Asked Questions

Is abiraterone acetate 250 MG Oral Tablet [Abirtega] covered by Medicare Part D?

Yes, abiraterone acetate 250 MG Oral Tablet [Abirtega] is covered by 4,655 Medicare Part D plans (91.9% of all Part D formularies).

What tier is abiraterone acetate 250 MG Oral Tablet [Abirtega] on Medicare Part D plans?

abiraterone acetate 250 MG Oral Tablet [Abirtega] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does abiraterone acetate 250 MG Oral Tablet [Abirtega] require prior authorization?

85.2% of Part D formularies require prior authorization for abiraterone acetate 250 MG Oral Tablet [Abirtega]. Step therapy: 0%. Quantity limits: 86.5%.

How much does Medicare spend on abiraterone acetate 250 MG Oral Tablet [Abirtega]?

In 2023, total Medicare Part D spending on abiraterone acetate 250 MG Oral Tablet [Abirtega] was $877,469,517, covering 45,661 beneficiaries. The average spend per beneficiary was $19,217.05.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial