canagliflozin 100 MG Oral Tablet [Invokana]
canagliflozin
RxCUI: 1373469
What the CMS Formulary Data Shows for canagliflozin 100 MG Oral Tablet [Invokana]
Per the CMS 2026 Part D formulary file, canagliflozin 100 MG Oral Tablet [Invokana] (RxNorm concept RXCUI 1373469, generic name canagliflozin) appears on 19 distinct formulary files spanning 695 Medicare Part D plan offerings - 13.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.5.
Real-world access to canagliflozin 100 MG Oral Tablet [Invokana] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 69,576 Part D beneficiaries filled canagliflozin 100 MG Oral Tablet [Invokana] in 2023, with total plan-and-beneficiary spending of $357,419,494 and an average per-beneficiary annual cost of $5,137.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry canagliflozin 100 MG Oral Tablet [Invokana] today.
Coverage Details
- Formularies covering
- 19
- Plans covering
- 695
- Coverage rate
- 13.7%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 69,576
- Total spending
- $357,419,494
- Avg per beneficiary
- $5,137.11
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering canagliflozin 100 MG Oral Tablet [Invokana]
1 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Wellcare Dual Liberty (HMO D-SNP) | WELLCARE OF CONNECTICUT, INC. | T3 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering canagliflozin 100 MG Oral Tablet [Invokana]
99 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Gold Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T3 | No | $0 | FL |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T3 | No | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T3 | No | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T3 | No | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T3 | No | $0 | AZ |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T3 | No | $0 | CA |
Frequently Asked Questions
Is canagliflozin 100 MG Oral Tablet [Invokana] covered by Medicare Part D?
Yes, canagliflozin 100 MG Oral Tablet [Invokana] is covered by 695 Medicare Part D plans (13.7% of all Part D formularies).
What tier is canagliflozin 100 MG Oral Tablet [Invokana] on Medicare Part D plans?
canagliflozin 100 MG Oral Tablet [Invokana] averages Tier 3.5 across Part D plans, ranging from Tier 2 to Tier 4.
Does canagliflozin 100 MG Oral Tablet [Invokana] require prior authorization?
0% of Part D formularies require prior authorization for canagliflozin 100 MG Oral Tablet [Invokana]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on canagliflozin 100 MG Oral Tablet [Invokana]?
In 2023, total Medicare Part D spending on canagliflozin 100 MG Oral Tablet [Invokana] was $357,419,494, covering 69,576 beneficiaries. The average spend per beneficiary was $5,137.11.
Read our methodology - how this data is sourced, computed, and verified.