eltrombopag 12.5 MG Oral Tablet [Promacta]
eltrombopag
RxCUI: 1245003
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.
20.1%
Plan Coverage
1,021
Plans Covering
T4.8
Avg Tier
100%
Prior Auth Required
What the CMS Formulary Data Shows for eltrombopag 12.5 MG Oral Tablet [Promacta]
Per the CMS 2026 Part D formulary file, eltrombopag 12.5 MG Oral Tablet [Promacta] (RxNorm concept RXCUI 1245003, generic name eltrombopag) appears on 22 distinct formulary files spanning 1,021 Medicare Part D plan offerings - 20.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.8.
Real-world access to eltrombopag 12.5 MG Oral Tablet [Promacta] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 95.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 5,708 Part D beneficiaries filled eltrombopag 12.5 MG Oral Tablet [Promacta] in 2023, with total plan-and-beneficiary spending of $557,676,106 and an average per-beneficiary annual cost of $97,700.79. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry eltrombopag 12.5 MG Oral Tablet [Promacta] today.
Coverage Details
- Formularies covering
- 22
- Plans covering
- 1,021
- Coverage rate
- 20.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 95.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,708
- Total spending
- $557,676,106
- Avg per beneficiary
- $97,700.79
Tier Distribution Across Plans
2 plans
Tier 1, Preferred Generic
98 plans
Tier 5, Specialty
Standalone Drug Plans (PDP) Covering eltrombopag 12.5 MG Oral Tablet [Promacta]
26 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering eltrombopag 12.5 MG Oral Tablet [Promacta]
74 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| Health New England Medicare Compass (PPO) | HEALTH NEW ENGLAND, INC. | T5 | Yes | $0 | MA |
| Health New England Medicare Value (HMO) | HEALTH NEW ENGLAND, INC. | T5 | Yes | $0 | MA |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| Health First Rewards H1099-014 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | HEALTH FIRST HEALTH PLANS | T5 | Yes | $0 | FL |
| Humana Gold Plus H0028-014 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | IL, MO |
| Humana Gold Plus H0028-019 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | NM |
| Humana Gold Plus H0028-021 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-024 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-028 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-029 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus H0028-030 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) | CHA HMO, INC. | T5 | Yes | $0 | TX |
Frequently Asked Questions
Is eltrombopag 12.5 MG Oral Tablet [Promacta] covered by Medicare Part D?
Yes, eltrombopag 12.5 MG Oral Tablet [Promacta] is covered by 1,021 Medicare Part D plans (20.1% of all Part D formularies).
What tier is eltrombopag 12.5 MG Oral Tablet [Promacta] on Medicare Part D plans?
eltrombopag 12.5 MG Oral Tablet [Promacta] averages Tier 4.8 across Part D plans, ranging from Tier 1 to Tier 5.
Does eltrombopag 12.5 MG Oral Tablet [Promacta] require prior authorization?
100% of Part D formularies require prior authorization for eltrombopag 12.5 MG Oral Tablet [Promacta]. Step therapy: 0%. Quantity limits: 95.5%.
How much does Medicare spend on eltrombopag 12.5 MG Oral Tablet [Promacta]?
In 2023, total Medicare Part D spending on eltrombopag 12.5 MG Oral Tablet [Promacta] was $557,676,106, covering 5,708 beneficiaries. The average spend per beneficiary was $97,700.79.
Read our methodology - how this data is sourced, computed, and verified.
Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial