ethosuximide 250 MG Oral Capsule [Zarontin]
ethosuximide
RxCUI: 201737
What the CMS Formulary Data Shows for ethosuximide 250 MG Oral Capsule [Zarontin]
Per the CMS 2026 Part D formulary file, ethosuximide 250 MG Oral Capsule [Zarontin] (RxNorm concept RXCUI 201737, generic name ethosuximide) appears on 2 distinct formulary files 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 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to ethosuximide 250 MG Oral Capsule [Zarontin] depends on utilization management as much as tier placement: 0% 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 2,145 Part D beneficiaries filled ethosuximide 250 MG Oral Capsule [Zarontin] in 2023, with total plan-and-beneficiary spending of $2,036,964 and an average per-beneficiary annual cost of $949.63. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ethosuximide 250 MG Oral Capsule [Zarontin] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 8
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,145
- Total spending
- $2,036,964
- Avg per beneficiary
- $949.63
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ethosuximide 250 MG Oral Capsule [Zarontin]
8 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 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | No | $0 | PR |
Frequently Asked Questions
Is ethosuximide 250 MG Oral Capsule [Zarontin] covered by Medicare Part D?
Yes, ethosuximide 250 MG Oral Capsule [Zarontin] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).
What tier is ethosuximide 250 MG Oral Capsule [Zarontin] on Medicare Part D plans?
ethosuximide 250 MG Oral Capsule [Zarontin] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does ethosuximide 250 MG Oral Capsule [Zarontin] require prior authorization?
0% of Part D formularies require prior authorization for ethosuximide 250 MG Oral Capsule [Zarontin]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on ethosuximide 250 MG Oral Capsule [Zarontin]?
In 2023, total Medicare Part D spending on ethosuximide 250 MG Oral Capsule [Zarontin] was $2,036,964, covering 2,145 beneficiaries. The average spend per beneficiary was $949.63.
Read our methodology - how this data is sourced, computed, and verified.