Medicare Part D coverage · everolimus · RxCUI 2685202
everolimus 2.5 MG Oral Tablet [Torpenz]
Per the CMS 2026 Part D formulary file, everolimus 2.5 MG Oral Tablet [Torpenz] is covered by 3,877 Medicare Part D plans (76.7% of enrollable products), averaging Tier 4.2, with prior authorization required on 99.2% of covering formularies.
- 76.7%
- Plan coverage
- 3,877
- Plans covering
- T4.2
- Avg tier
- 99.2%
- Prior auth required
What the CMS Formulary Data Shows for everolimus 2.5 MG Oral Tablet [Torpenz]
Per the CMS 2026 Part D formulary file, everolimus 2.5 MG Oral Tablet [Torpenz] (RxNorm concept RXCUI 2685202, generic name everolimus) appears on 236 distinct formulary files spanning 3,877 Medicare Part D plan offerings - 76.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to everolimus 2.5 MG Oral Tablet [Torpenz] depends on utilization management as much as tier placement: 99.2% of covering formularies require prior authorization. 0% require step therapy. 93.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,726 Part D beneficiaries filled everolimus 2.5 MG Oral Tablet [Torpenz] in 2023, with total plan-and-beneficiary spending of $240,732,669 and an average per-beneficiary annual cost of $35,791.36. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry everolimus 2.5 MG Oral Tablet [Torpenz] today.
Coverage Details
- Formularies covering
- 236
- Plans covering
- 3,877
- Coverage rate
- 76.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 99.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 93.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,726
- Total spending
- $240,732,669
- Avg per beneficiary
- $35,791.36
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering everolimus 2.5 MG Oral Tablet [Torpenz]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
Show the next 30 plans
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| 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 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is everolimus 2.5 MG Oral Tablet [Torpenz] covered by Medicare Part D?
Yes, everolimus 2.5 MG Oral Tablet [Torpenz] is covered by 3,877 Medicare Part D plans (76.7% of all Part D formularies).
What tier is everolimus 2.5 MG Oral Tablet [Torpenz] on Medicare Part D plans?
everolimus 2.5 MG Oral Tablet [Torpenz] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does everolimus 2.5 MG Oral Tablet [Torpenz] require prior authorization?
99.2% of Part D formularies require prior authorization for everolimus 2.5 MG Oral Tablet [Torpenz]. Step therapy: 0%. Quantity limits: 93.2%.
How much does Medicare spend on everolimus 2.5 MG Oral Tablet [Torpenz]?
In 2023, total Medicare Part D spending on everolimus 2.5 MG Oral Tablet [Torpenz] was $240,732,669, covering 6,726 beneficiaries. The average spend per beneficiary was $35,791.36.
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
Similar prior-authorization rate
- levalbuterol 0.103 MG/ML Inhalation Solution 99.2% PA
- levalbuterol 2.5 MG/ML Inhalation Solution 99.2% PA
- epoetin alfa-epbx 10000 UNT/ML Injectable Solution [Retacrit] 99.2% PA
- 1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit] 99.2% PA
- 1 ML epoetin alfa-epbx 40000 UNT/ML Injection [Retacrit] 99.2% PA
- eltrombopag 18 MG Oral Tablet [Alvaiz] 99.2% PA