bempedoic acid 180 MG Oral Tablet [Nexletol]
bempedoic acid
RxCUI: 2282414
What the CMS Formulary Data Shows for bempedoic acid 180 MG Oral Tablet [Nexletol]
Per the CMS 2026 Part D formulary file, bempedoic acid 180 MG Oral Tablet [Nexletol] (RxNorm concept RXCUI 2282414, generic name bempedoic acid) appears on 279 distinct formulary files spanning 4,735 Medicare Part D plan offerings - 93.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.8.
Real-world access to bempedoic acid 180 MG Oral Tablet [Nexletol] depends on utilization management as much as tier placement: 57.7% of covering formularies require prior authorization. 19.4% require step therapy. 82.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 18,619 Part D beneficiaries filled bempedoic acid 180 MG Oral Tablet [Nexletol] in 2023, with total plan-and-beneficiary spending of $45,523,814 and an average per-beneficiary annual cost of $2,445.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bempedoic acid 180 MG Oral Tablet [Nexletol] today.
Coverage Details
- Formularies covering
- 279
- Plans covering
- 4,735
- Coverage rate
- 93.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 57.7% of formularies
- Step therapy required
- 19.4% of formularies
- Quantity limits
- 82.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 18,619
- Total spending
- $45,523,814
- Avg per beneficiary
- $2,445.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering bempedoic acid 180 MG Oral Tablet [Nexletol]
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 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | HEALTH CHOICE ARIZONA, INC. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | HEALTHFIRST HEALTH PLAN, INC. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | ITASCA MEDICAL CARE | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | HOPKINS HEALTH ADVANTAGE, INC. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | METROPLUS HEALTH PLAN, INC. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | Yes | $0 | AL |
| 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 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | Yes | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | Yes | $0 | WI |
| 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 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
Frequently Asked Questions
Is bempedoic acid 180 MG Oral Tablet [Nexletol] covered by Medicare Part D?
Yes, bempedoic acid 180 MG Oral Tablet [Nexletol] is covered by 4,735 Medicare Part D plans (93.4% of all Part D formularies).
What tier is bempedoic acid 180 MG Oral Tablet [Nexletol] on Medicare Part D plans?
bempedoic acid 180 MG Oral Tablet [Nexletol] averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does bempedoic acid 180 MG Oral Tablet [Nexletol] require prior authorization?
57.7% of Part D formularies require prior authorization for bempedoic acid 180 MG Oral Tablet [Nexletol]. Step therapy: 19.4%. Quantity limits: 82.8%.
How much does Medicare spend on bempedoic acid 180 MG Oral Tablet [Nexletol]?
In 2023, total Medicare Part D spending on bempedoic acid 180 MG Oral Tablet [Nexletol] was $45,523,814, covering 18,619 beneficiaries. The average spend per beneficiary was $2,445.02.
Read our methodology - how this data is sourced, computed, and verified.