Medicare Part D coverage · alogliptin · RxCUI 1368034
alogliptin 12.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, alogliptin 12.5 MG Oral Tablet is covered by 75 Medicare Part D plans (1.5% of enrollable products), averaging Tier 1.8, with prior authorization required on 9.1% of covering formularies.
- 1.5%
- Plan coverage
- 75
- Plans covering
- T1.8
- Avg tier
- 9.1%
- Prior auth required
What the CMS Formulary Data Shows for alogliptin 12.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, alogliptin 12.5 MG Oral Tablet (RxNorm concept RXCUI 1368034, generic name alogliptin) appears on 11 distinct formulary files spanning 75 Medicare Part D plan offerings - 1.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.8.
Real-world access to alogliptin 12.5 MG Oral Tablet depends on utilization management as much as tier placement: 9.1% of covering formularies require prior authorization. 0% require step therapy. 81.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 17,642 Part D beneficiaries filled alogliptin 12.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $14,741,684 and an average per-beneficiary annual cost of $835.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry alogliptin 12.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 75
- Coverage rate
- 1.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 9.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 81.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 17,642
- Total spending
- $14,741,684
- Avg per beneficiary
- $835.60
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering alogliptin 12.5 MG Oral Tablet
75 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T1 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T1 | No | $0 | NV |
| Personal Choice 65 Achieve Rx (PPO) | QCC Insurance Company | T1 | No | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T1 | No | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T1 | No | $0 | PA |
| Keystone 65 Basic Rx (HMO) | Keystone Health Plan East, Inc. | T1 | No | $0 | PA |
| AmeriHealth Medicare Core (PPO) | Amerihealth Insurance Company OF NEW Jersey | T1 | No | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | Amerihealth Insurance Company OF NEW Jersey | T1 | No | $0 | NJ |
Show the next 30 plans
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| MMM Supremo (HMO C-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Keystone 65 Essential Rx (HMO-POS) | Keystone Health Plan East, Inc. | T1 | No | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | Amerihealth Insurance Company OF NEW Jersey | T1 | No | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T1 | No | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T1 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T1 | No | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T1 | No | $79.70 | PA |
| Personal Choice 65 Plus Rx (PPO) | QCC Insurance Company | T1 | No | $81.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC Insurance Company | T1 | No | $102.20 | PA |
Showing top 50 of 75 plans.
Frequently Asked Questions
Is alogliptin 12.5 MG Oral Tablet covered by Medicare Part D?
Yes, alogliptin 12.5 MG Oral Tablet is covered by 75 Medicare Part D plans (1.5% of all Part D formularies).
What tier is alogliptin 12.5 MG Oral Tablet on Medicare Part D plans?
alogliptin 12.5 MG Oral Tablet averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does alogliptin 12.5 MG Oral Tablet require prior authorization?
9.1% of Part D formularies require prior authorization for alogliptin 12.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 81.8%.
How much does Medicare spend on alogliptin 12.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on alogliptin 12.5 MG Oral Tablet was $14,741,684, covering 17,642 beneficiaries. The average spend per beneficiary was $835.60.
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
- fluconazole 50 MG Oral Tablet T1.8
- Smoking Cessation 12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet T1.8
- metolazone 5 MG Oral Tablet T1.8
- doxycycline monohydrate 50 MG Oral Capsule T1.8
- trihexyphenidyl hydrochloride 2 MG Oral Tablet T1.8
- Microencapsulated potassium chloride 15 MEQ Extended Release Oral Tablet [Klor-Con] T1.8