Medicare Part D coverage · amifampridine · RxCUI 2107518
amifampridine 10 MG Oral Tablet [Firdapse]
Per the CMS 2026 Part D formulary file, amifampridine 10 MG Oral Tablet [Firdapse] is covered by 211 Medicare Part D plans (4.2% of enrollable products), averaging Tier 4.7, with prior authorization required on 96.4% of covering formularies.
- 4.2%
- Plan coverage
- 211
- Plans covering
- T4.7
- Avg tier
- 96.4%
- Prior auth required
What the CMS Formulary Data Shows for amifampridine 10 MG Oral Tablet [Firdapse]
Per the CMS 2026 Part D formulary file, amifampridine 10 MG Oral Tablet [Firdapse] (RxNorm concept RXCUI 2107518, generic name amifampridine) appears on 28 distinct formulary files spanning 211 Medicare Part D plan offerings - 4.2% 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 4.7.
Real-world access to amifampridine 10 MG Oral Tablet [Firdapse] depends on utilization management as much as tier placement: 96.4% of covering formularies require prior authorization. 0% require step therapy. 28.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 356 Part D beneficiaries filled amifampridine 10 MG Oral Tablet [Firdapse] in 2023, with total plan-and-beneficiary spending of $146,333,212 and an average per-beneficiary annual cost of $411,048.35. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry amifampridine 10 MG Oral Tablet [Firdapse] today.
Coverage Details
- Formularies covering
- 28
- Plans covering
- 211
- Coverage rate
- 4.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 96.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 28.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 356
- Total spending
- $146,333,212
- Avg per beneficiary
- $411,048.35
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering amifampridine 10 MG Oral Tablet [Firdapse]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
Show the next 30 plans
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| 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 |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | Yes | $0 | NY |
| Geisinger Gold Preferred Complete Rx (PPO) | Geisinger Indemnity Insurance Company | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Troy Medicare (HMO) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T5 | Yes | $0 | NC |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is amifampridine 10 MG Oral Tablet [Firdapse] covered by Medicare Part D?
Yes, amifampridine 10 MG Oral Tablet [Firdapse] is covered by 211 Medicare Part D plans (4.2% of all Part D formularies).
What tier is amifampridine 10 MG Oral Tablet [Firdapse] on Medicare Part D plans?
amifampridine 10 MG Oral Tablet [Firdapse] averages Tier 4.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does amifampridine 10 MG Oral Tablet [Firdapse] require prior authorization?
96.4% of Part D formularies require prior authorization for amifampridine 10 MG Oral Tablet [Firdapse]. Step therapy: 0%. Quantity limits: 28.6%.
How much does Medicare spend on amifampridine 10 MG Oral Tablet [Firdapse]?
In 2023, total Medicare Part D spending on amifampridine 10 MG Oral Tablet [Firdapse] was $146,333,212, covering 356 beneficiaries. The average spend per beneficiary was $411,048.35.
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
- lonafarnib 50 MG Oral Capsule [Zokinvy] T4.7
- methyltestosterone 10 MG Oral Tablet [Methitest] T4.7
- nitisinone 10 MG Oral Tablet [Nityr] T4.7
- buspirone hydrochloride 15 MG Oral Capsule [Bucapsol] T4.7
- 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe T4.7
- 0.2 ML adalimumab-adaz 100 MG/ML Prefilled Syringe T4.7
Similar prior-authorization rate
- dichlorphenamide 50 MG Oral Tablet 96.4% PA
- {28 (elagolix 300 MG / estradiol 1 MG / norethindrone 0.5 MG Oral Capsule) / 28 (elagolix 300 MG Oral Capsule) } Pack [Oriahnn 28 Day Kit] 96.4% PA
- armodafinil 250 MG Oral Tablet 96.5% PA
- armodafinil 150 MG Oral Tablet 96.5% PA
- 1 ML darbepoetin alfa 0.1 MG/ML Injection [Aranesp] 96.5% PA
- 1 ML darbepoetin alfa 0.2 MG/ML Injection [Aranesp] 96.5% PA