Medicare Part D coverage · aprepitant · RxCUI 1729311
aprepitant 125 MG Powder for Oral Suspension [Emend]
Per the CMS 2026 Part D formulary file, aprepitant 125 MG Powder for Oral Suspension [Emend] is covered by 813 Medicare Part D plans (16.1% of enrollable products), averaging Tier 3.4, with prior authorization required on 100% of covering formularies.
- 16.1%
- Plan coverage
- 813
- 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 813 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
- 813
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 813 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.
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
- artemether 20 MG / lumefantrine 120 MG Oral Tablet [Coartem] T3.4
- nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray [Nicotrol] T3.4
- magnesium chloride 0.00148 MEQ/ML / monobasic potassium phosphate 0.0082 MG/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.0272 MEQ/ML / sodium chloride 0.0906 MEQ/ML / sodium gluconate 5 MG/ML / sodium phosphate, dibasic 0.12 MG/ML Injectable Solution [Isolyte S] T3.4
- soybean oil 300 MG/ML Injectable Suspension [Intralipid] T3.4
- 1 ML epoetin alfa-epbx 40000 UNT/ML Injection [Retacrit] T3.4
- lactulose 20000 MG Powder for Oral Solution T3.4
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA