ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan]
ertugliflozin
RxCUI: 1992837
What the CMS Formulary Data Shows for ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan]
Per the CMS 2026 Part D formulary file, ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] (RxNorm concept RXCUI 1992837, generic name ertugliflozin) appears on 1 distinct formulary file spanning 8 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 722 Part D beneficiaries filled ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] in 2023, with total plan-and-beneficiary spending of $1,266,291 and an average per-beneficiary annual cost of $1,753.87. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 8
- Coverage rate
- 0.2%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 722
- Total spending
- $1,266,291
- Avg per beneficiary
- $1,753.87
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan]
8 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $21.10 | WI |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $38.60 | WI |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $92.80 | WI |
Frequently Asked Questions
Is ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] covered by Medicare Part D?
Yes, ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).
What tier is ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] on Medicare Part D plans?
ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] require prior authorization?
100% of Part D formularies require prior authorization for ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan]?
In 2023, total Medicare Part D spending on ertugliflozin 5 MG / sitagliptin 100 MG Oral Tablet [Steglujan] was $1,266,291, covering 722 beneficiaries. The average spend per beneficiary was $1,753.87.
Read our methodology - how this data is sourced, computed, and verified.