bosentan 125 MG Oral Tablet [Tracleer]
bosentan
RxCUI: 656660
What the CMS Formulary Data Shows for bosentan 125 MG Oral Tablet [Tracleer]
Per the CMS 2026 Part D formulary file, bosentan 125 MG Oral Tablet [Tracleer] (RxNorm concept RXCUI 656660, generic name bosentan) appears on 7 distinct formulary files spanning 43 Medicare Part D plan offerings - 0.8% 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 4.4.
Real-world access to bosentan 125 MG Oral Tablet [Tracleer] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 71.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 715 Part D beneficiaries filled bosentan 125 MG Oral Tablet [Tracleer] in 2023, with total plan-and-beneficiary spending of $34,313,416 and an average per-beneficiary annual cost of $47,990.79. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bosentan 125 MG Oral Tablet [Tracleer] today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 43
- Coverage rate
- 0.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 71.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 715
- Total spending
- $34,313,416
- Avg per beneficiary
- $47,990.79
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering bosentan 125 MG Oral Tablet [Tracleer]
43 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T5 | Yes | $0 | FL |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T5 | Yes | $0 | FL |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Beyond (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Beyond (HMO-POS) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T5 | Yes | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST | T5 | Yes | $0 | NV |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T5 | Yes | $0 | FL |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Diabetes and Heart Care Plus (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Diabetes and Heart Giveback (HMO C-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T5 | Yes | $4.20 | NV |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T5 | Yes | $4.80 | FL |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T5 | Yes | $4.80 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST | T5 | Yes | $9.50 | NV |
| Keystone 65 Essential Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $79.70 | PA |
| Personal Choice 65 Plus Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $81.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $112.70 | PA |
Frequently Asked Questions
Is bosentan 125 MG Oral Tablet [Tracleer] covered by Medicare Part D?
Yes, bosentan 125 MG Oral Tablet [Tracleer] is covered by 43 Medicare Part D plans (0.8% of all Part D formularies).
What tier is bosentan 125 MG Oral Tablet [Tracleer] on Medicare Part D plans?
bosentan 125 MG Oral Tablet [Tracleer] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does bosentan 125 MG Oral Tablet [Tracleer] require prior authorization?
100% of Part D formularies require prior authorization for bosentan 125 MG Oral Tablet [Tracleer]. Step therapy: 0%. Quantity limits: 71.4%.
How much does Medicare spend on bosentan 125 MG Oral Tablet [Tracleer]?
In 2023, total Medicare Part D spending on bosentan 125 MG Oral Tablet [Tracleer] was $34,313,416, covering 715 beneficiaries. The average spend per beneficiary was $47,990.79.
Read our methodology - how this data is sourced, computed, and verified.