cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]

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cyclosporine

RxCUI: 2055026

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.
2.9%
Plan Coverage
149
Plans Covering
T3.2
Avg Tier
20%
Prior Auth Required

What the CMS Formulary Data Shows for cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]

Per the CMS 2026 Part D formulary file, cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] (RxNorm concept RXCUI 2055026, generic name cyclosporine) appears on 10 distinct formulary files spanning 149 Medicare Part D plan offerings - 2.9% 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 3.2.

Real-world access to cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] depends on utilization management as much as tier placement: 20% of covering formularies require prior authorization. 0% require step therapy. 30% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 492,479 Part D beneficiaries filled cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] 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 0.9 MG/ML Ophthalmic Solution [Cequa] today.

Coverage Details

Formularies covering
10
Plans covering
149
Coverage rate
2.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
20% of formularies
Step therapy required
0% of formularies
Quantity limits
30% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

1 plans
Tier 1, Preferred Generic
4 plans
Tier 2, Generic
95 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]

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

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Leon MediExtra (HMO) LEON HEALTH, INC. T2 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T2 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T2 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T2 No $0 FL
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic (HMO) KAISER FOUNDATION HP, INC. T3 No $0 HI
Kaiser Permanente Medicare Advantage Value 1 VA (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 VA
Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Dual Complete Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Dual Essential Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD

Frequently Asked Questions

Is cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] covered by Medicare Part D?

Yes, cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] is covered by 149 Medicare Part D plans (2.9% of all Part D formularies).

What tier is cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] on Medicare Part D plans?

cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] require prior authorization?

20% of Part D formularies require prior authorization for cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]. Step therapy: 0%. Quantity limits: 30%.

How much does Medicare spend on cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]?

In 2023, total Medicare Part D spending on cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa] 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