glycopyrrolate 1.5 MG Oral Tablet

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glycopyrrolate

RxCUI: 1247658

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.
2.3%
Plan Coverage
117
Plans Covering
T1.5
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for glycopyrrolate 1.5 MG Oral Tablet

Per the CMS 2026 Part D formulary file, glycopyrrolate 1.5 MG Oral Tablet (RxNorm concept RXCUI 1247658, generic name glycopyrrolate) appears on 4 distinct formulary files spanning 117 Medicare Part D plan offerings - 2.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 2, with a cross-plan average of Tier 1.5.

Real-world access to glycopyrrolate 1.5 MG Oral Tablet 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 51,524 Part D beneficiaries filled glycopyrrolate 1.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $11,621,261 and an average per-beneficiary annual cost of $225.55. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry glycopyrrolate 1.5 MG Oral Tablet today.

Coverage Details

Formularies covering
4
Plans covering
117
Coverage rate
2.3%
Tier range
Tier 1 – Tier 2
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
51,524
Total spending
$11,621,261
Avg per beneficiary
$225.55

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
98 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering glycopyrrolate 1.5 MG Oral Tablet

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF CO T2 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T2 No $0 GA
Kaiser Permanente Senior Advantage Basic (HMO) KAISER FOUNDATION HP, INC. T2 No $0 HI
Kaiser Permanente Medicare Advantage Value 1 VA (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 VA
Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Complete Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Essential Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD
Kaiser Permanente Medicare Advantage Standard DC (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 DC
Kaiser Permanente Medicare Advantage Standard 2 MD (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T2 No $0 MD

Frequently Asked Questions

Is glycopyrrolate 1.5 MG Oral Tablet covered by Medicare Part D?

Yes, glycopyrrolate 1.5 MG Oral Tablet is covered by 117 Medicare Part D plans (2.3% of all Part D formularies).

What tier is glycopyrrolate 1.5 MG Oral Tablet on Medicare Part D plans?

glycopyrrolate 1.5 MG Oral Tablet averages Tier 1.5 across Part D plans, ranging from Tier 1 to Tier 2.

Does glycopyrrolate 1.5 MG Oral Tablet require prior authorization?

0% of Part D formularies require prior authorization for glycopyrrolate 1.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on glycopyrrolate 1.5 MG Oral Tablet?

In 2023, total Medicare Part D spending on glycopyrrolate 1.5 MG Oral Tablet was $11,621,261, covering 51,524 beneficiaries. The average spend per beneficiary was $225.55.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial