alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira]
alpha
RxCUI: 991722
What the CMS Formulary Data Shows for alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira]
Per the CMS 2026 Part D formulary file, alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] (RxNorm concept RXCUI 991722, generic name alpha) appears on 88 distinct formulary files spanning 1,600 Medicare Part D plan offerings - 31.6% 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 4.2.
Real-world access to alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 226 Part D beneficiaries filled alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] in 2023, with total plan-and-beneficiary spending of $27,922,300 and an average per-beneficiary annual cost of $123,550.00. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] today.
Coverage Details
- Formularies covering
- 88
- Plans covering
- 1,600
- Coverage rate
- 31.6%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 226
- Total spending
- $27,922,300
- Avg per beneficiary
- $123,550.00
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $0 | FL |
| 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 |
| 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 |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | Yes | $0 | MA |
| 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 |
| CCA One Care (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | Yes | $0 | WI |
| 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 |
| Florida Complete Care (HMO I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | ELDERPLAN, INC. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $58.80 | NY |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| BlueCare Plus (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T4 | Yes | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T4 | Yes | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | VOLUNTEER STATE HEALTH PLAN | T4 | Yes | $0 | TN |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T5 | Yes | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T5 | Yes | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
| HAP Medicare Superior (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
| Henry Ford Select (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
| Sharp Direct Advantage Gold (HMO) | SHARP HEALTH PLAN | T5 | Yes | $0 | CA |
| Sharp Direct Advantage VIP (HMO) | SHARP HEALTH PLAN | T5 | Yes | $0 | CA |
| Sharp Direct Advantage VIP Plus (HMO) | SHARP HEALTH PLAN | T5 | Yes | $0 | CA |
| Blue Medicare Advantage PPO (PPO) | WELLMARK ADVANTAGE HEALTH PLAN, INC. | T5 | Yes | $0 | IA |
| BlueMedicare Premier (HMO) | USABLE HMO, INC. | T5 | Yes | $0 | AR |
Frequently Asked Questions
Is alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] covered by Medicare Part D?
Yes, alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] is covered by 1,600 Medicare Part D plans (31.6% of all Part D formularies).
What tier is alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] on Medicare Part D plans?
alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] require prior authorization?
100% of Part D formularies require prior authorization for alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira]?
In 2023, total Medicare Part D spending on alpha 1-proteinase inhibitor, human 1 MG Injection [Zemaira] was $27,922,300, covering 226 beneficiaries. The average spend per beneficiary was $123,550.00.
Read our methodology - how this data is sourced, computed, and verified.