glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti]
glycerol phenylbutyrate
RxCUI: 1368459
What the CMS Formulary Data Shows for glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti]
Per the CMS 2026 Part D formulary file, glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] (RxNorm concept RXCUI 1368459, generic name glycerol phenylbutyrate) appears on 2 distinct formulary files spanning 10 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 5, with a cross-plan average of Tier 3.
Real-world access to glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] depends on utilization management as much as tier placement: 100% 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 87 Part D beneficiaries filled glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] in 2023, with total plan-and-beneficiary spending of $73,454,459 and an average per-beneficiary annual cost of $844,304.13. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 10
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 87
- Total spending
- $73,454,459
- Avg per beneficiary
- $844,304.13
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti]
10 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | Yes | $0 | PR |
Frequently Asked Questions
Is glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] covered by Medicare Part D?
Yes, glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).
What tier is glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] on Medicare Part D plans?
glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.
Does glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] require prior authorization?
100% of Part D formularies require prior authorization for glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti]?
In 2023, total Medicare Part D spending on glycerol phenylbutyrate 1100 MG/ML Oral Solution [Ravicti] was $73,454,459, covering 87 beneficiaries. The average spend per beneficiary was $844,304.13.
Read our methodology - how this data is sourced, computed, and verified.