aprepitant 125 MG Powder for Oral Suspension [Emend]

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aprepitant

RxCUI: 1729311

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.
16.1%
Plan Coverage
814
Plans Covering
T3.4
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for aprepitant 125 MG Powder for Oral Suspension [Emend]

Per the CMS 2026 Part D formulary file, aprepitant 125 MG Powder for Oral Suspension [Emend] (RxNorm concept RXCUI 1729311, generic name aprepitant) appears on 45 distinct formulary files spanning 814 Medicare Part D plan offerings - 16.1% 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 3.4.

Real-world access to aprepitant 125 MG Powder for Oral Suspension [Emend] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 42.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,705 Part D beneficiaries filled aprepitant 125 MG Powder for Oral Suspension [Emend] in 2023, with total plan-and-beneficiary spending of $8,623,535 and an average per-beneficiary annual cost of $1,832.84. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry aprepitant 125 MG Powder for Oral Suspension [Emend] today.

Coverage Details

Formularies covering
45
Plans covering
814
Coverage rate
16.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
42.2% of formularies

2023 Medicare Spending

Beneficiaries
4,705
Total spending
$8,623,535
Avg per beneficiary
$1,832.84

Tier Distribution Across Plans

18 plans
Tier 1, Preferred Generic
50 plans
Tier 3, Preferred Brand
32 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering aprepitant 125 MG Powder for Oral Suspension [Emend]

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
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
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
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY 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
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 Yes $17.00 AZ
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
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T3 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T3 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 Yes $0 FL

Frequently Asked Questions

Is aprepitant 125 MG Powder for Oral Suspension [Emend] covered by Medicare Part D?

Yes, aprepitant 125 MG Powder for Oral Suspension [Emend] is covered by 814 Medicare Part D plans (16.1% of all Part D formularies).

What tier is aprepitant 125 MG Powder for Oral Suspension [Emend] on Medicare Part D plans?

aprepitant 125 MG Powder for Oral Suspension [Emend] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does aprepitant 125 MG Powder for Oral Suspension [Emend] require prior authorization?

100% of Part D formularies require prior authorization for aprepitant 125 MG Powder for Oral Suspension [Emend]. Step therapy: 0%. Quantity limits: 42.2%.

How much does Medicare spend on aprepitant 125 MG Powder for Oral Suspension [Emend]?

In 2023, total Medicare Part D spending on aprepitant 125 MG Powder for Oral Suspension [Emend] was $8,623,535, covering 4,705 beneficiaries. The average spend per beneficiary was $1,832.84.

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