Medicare Part D coverage · cysteamine · RxCUI 1313785
cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran]
Per the CMS 2026 Part D formulary file, cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] is covered by 4,744 Medicare Part D plans (93.9% of enrollable products), averaging Tier 4.4, with prior authorization required on 78.2% of covering formularies.
- 93.9%
- Plan coverage
- 4,744
- Plans covering
- T4.4
- Avg tier
- 78.2%
- Prior auth required
What the CMS Formulary Data Shows for cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran]
Per the CMS 2026 Part D formulary file, cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] (RxNorm concept RXCUI 1313785, generic name cysteamine) appears on 234 distinct formulary files spanning 4,744 Medicare Part D plan offerings - 93.9% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.4.
Real-world access to cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] depends on utilization management as much as tier placement: 78.2% of covering formularies require prior authorization. 0% require step therapy. 36.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 30 Part D beneficiaries filled cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] in 2023, with total plan-and-beneficiary spending of $2,301,078 and an average per-beneficiary annual cost of $76,702.62. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] today.
Coverage Details
- Formularies covering
- 234
- Plans covering
- 4,744
- Coverage rate
- 93.9%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 78.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 36.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 30
- Total spending
- $2,301,078
- Avg per beneficiary
- $76,702.62
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran]
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 |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] covered by Medicare Part D?
Yes, cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] is covered by 4,744 Medicare Part D plans (93.9% of all Part D formularies).
What tier is cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] on Medicare Part D plans?
cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 6.
Does cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] require prior authorization?
78.2% of Part D formularies require prior authorization for cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran]. Step therapy: 0%. Quantity limits: 36.8%.
How much does Medicare spend on cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran]?
In 2023, total Medicare Part D spending on cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] was $2,301,078, covering 30 beneficiaries. The average spend per beneficiary was $76,702.62.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- ceftaroline fosamil 600 MG Injection [Teflaro] T4.4
- sapropterin dihydrochloride 500 MG Powder for Oral Solution [Zelvysia] T4.4
- eliglustat 84 MG Oral Capsule [Cerdelga] T4.4
- {28 (alpelisib 50 MG Oral Granules [Vijoice]) } Pack [Vijoice 50 MG Granules 28 Day] T4.4
- sofosbuvir 200 MG Oral Tablet [Sovaldi] T4.4
- sinecatechins 0.15 MG/MG Topical Ointment [Veregen] T4.4
Similar prior-authorization rate
- ruxolitinib 15 MG/ML Topical Cream [Opzelura] 77.8% PA
- deferiprone 100 MG/ML Oral Solution [Ferriprox] 77.8% PA
- {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack 77.7% PA
- vigabatrin 500 MG Powder for Oral Solution 77.7% PA
- tazarotene 0.0005 MG/MG Topical Gel 78.9% PA
- triptorelin 3.75 MG Injection [Trelstar] 78.9% PA