cyclosporine 25 MG Oral Capsule

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cyclosporine

RxCUI: 197553

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.
100%
Plan Coverage
5,067
Plans Covering
T2.8
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for cyclosporine 25 MG Oral Capsule

Per the CMS 2026 Part D formulary file, cyclosporine 25 MG Oral Capsule (RxNorm concept RXCUI 197553, generic name cyclosporine) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% 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 cyclosporine 25 MG Oral Capsule depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 492,479 Part D beneficiaries filled cyclosporine 25 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $1,501,664,198 and an average per-beneficiary annual cost of $3,049.19. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cyclosporine 25 MG Oral Capsule today.

Coverage Details

Formularies covering
330
Plans covering
5,067
Coverage rate
100%
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
0% of formularies

2023 Medicare Spending

Beneficiaries
492,479
Total spending
$1,501,664,198
Avg per beneficiary
$3,049.19

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering cyclosporine 25 MG Oral Capsule

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Full Dual Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Full Dual Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Extra (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Complete Platinum (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply More Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Complete Platinum (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T1 Yes $0 FL

Frequently Asked Questions

Is cyclosporine 25 MG Oral Capsule covered by Medicare Part D?

Yes, cyclosporine 25 MG Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).

What tier is cyclosporine 25 MG Oral Capsule on Medicare Part D plans?

cyclosporine 25 MG Oral Capsule averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does cyclosporine 25 MG Oral Capsule require prior authorization?

100% of Part D formularies require prior authorization for cyclosporine 25 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on cyclosporine 25 MG Oral Capsule?

In 2023, total Medicare Part D spending on cyclosporine 25 MG Oral Capsule was $1,501,664,198, covering 492,479 beneficiaries. The average spend per beneficiary was $3,049.19.

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