cyclosporine, modified 25 MG Oral Capsule [Gengraf]
cyclosporine, modified
RxCUI: 835896
What the CMS Formulary Data Shows for cyclosporine, modified 25 MG Oral Capsule [Gengraf]
Per the CMS 2026 Part D formulary file, cyclosporine, modified 25 MG Oral Capsule [Gengraf] (RxNorm concept RXCUI 835896, generic name cyclosporine, modified) appears on 287 distinct formulary files spanning 4,103 Medicare Part D plan offerings - 81% 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, modified 25 MG Oral Capsule [Gengraf] depends on utilization management as much as tier placement: 99.7% 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, modified 25 MG Oral Capsule [Gengraf] 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, modified 25 MG Oral Capsule [Gengraf] today.
Coverage Details
- Formularies covering
- 287
- Plans covering
- 4,103
- Coverage rate
- 81%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 99.7% 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
Medicare Advantage Plans (MA-PD) Covering cyclosporine, modified 25 MG Oral Capsule [Gengraf]
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 |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Platinum Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Gold Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Gold Plus Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| 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 |
Frequently Asked Questions
Is cyclosporine, modified 25 MG Oral Capsule [Gengraf] covered by Medicare Part D?
Yes, cyclosporine, modified 25 MG Oral Capsule [Gengraf] is covered by 4,103 Medicare Part D plans (81% of all Part D formularies).
What tier is cyclosporine, modified 25 MG Oral Capsule [Gengraf] on Medicare Part D plans?
cyclosporine, modified 25 MG Oral Capsule [Gengraf] averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does cyclosporine, modified 25 MG Oral Capsule [Gengraf] require prior authorization?
99.7% of Part D formularies require prior authorization for cyclosporine, modified 25 MG Oral Capsule [Gengraf]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on cyclosporine, modified 25 MG Oral Capsule [Gengraf]?
In 2023, total Medicare Part D spending on cyclosporine, modified 25 MG Oral Capsule [Gengraf] was $1,501,664,198, covering 492,479 beneficiaries. The average spend per beneficiary was $3,049.19.
Read our methodology - how this data is sourced, computed, and verified.