glycopyrronium 24 MG/ML Medicated Pad [Qbrexza]
glycopyrronium
RxCUI: 2054120
What the CMS Formulary Data Shows for glycopyrronium 24 MG/ML Medicated Pad [Qbrexza]
Per the CMS 2026 Part D formulary file, glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] (RxNorm concept RXCUI 2054120, generic name glycopyrronium) appears on 4 distinct formulary files spanning 9 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 75% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 828 Part D beneficiaries filled glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] in 2023, with total plan-and-beneficiary spending of $1,842,539 and an average per-beneficiary annual cost of $2,225.29. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 9
- Coverage rate
- 0.2%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 75% of formularies
2023 Medicare Spending
- Beneficiaries
- 828
- Total spending
- $1,842,539
- Avg per beneficiary
- $2,225.29
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering glycopyrronium 24 MG/ML Medicated Pad [Qbrexza]
9 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T4 | Yes | $0 | OR |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | Yes | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | Yes | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | Yes | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T4 | Yes | $79.70 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | Yes | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T4 | Yes | $112.70 | PA |
Frequently Asked Questions
Is glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] covered by Medicare Part D?
Yes, glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] is covered by 9 Medicare Part D plans (0.2% of all Part D formularies).
What tier is glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] on Medicare Part D plans?
glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.
Does glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] require prior authorization?
100% of Part D formularies require prior authorization for glycopyrronium 24 MG/ML Medicated Pad [Qbrexza]. Step therapy: 0%. Quantity limits: 75%.
How much does Medicare spend on glycopyrronium 24 MG/ML Medicated Pad [Qbrexza]?
In 2023, total Medicare Part D spending on glycopyrronium 24 MG/ML Medicated Pad [Qbrexza] was $1,842,539, covering 828 beneficiaries. The average spend per beneficiary was $2,225.29.
Read our methodology - how this data is sourced, computed, and verified.