icosapent ethyl 1000 MG Oral Capsule
icosapent ethyl
RxCUI: 1304979
What the CMS Formulary Data Shows for icosapent ethyl 1000 MG Oral Capsule
Per the CMS 2026 Part D formulary file, icosapent ethyl 1000 MG Oral Capsule (RxNorm concept RXCUI 1304979, generic name icosapent ethyl) appears on 208 distinct formulary files spanning 1,626 Medicare Part D plan offerings - 32.1% 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 icosapent ethyl 1000 MG Oral Capsule depends on utilization management as much as tier placement: 0.5% of covering formularies require prior authorization. 0.5% require step therapy. 56.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 279,946 Part D beneficiaries filled icosapent ethyl 1000 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $763,988,447 and an average per-beneficiary annual cost of $2,729.06. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry icosapent ethyl 1000 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 208
- Plans covering
- 1,626
- Coverage rate
- 32.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0.5% of formularies
- Step therapy required
- 0.5% of formularies
- Quantity limits
- 56.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 279,946
- Total spending
- $763,988,447
- Avg per beneficiary
- $2,729.06
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering icosapent ethyl 1000 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | No | $0 | VA |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | SANTA CLARA COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T1 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T1 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T1 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T1 | No | $0 | NV |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST | T1 | No | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T1 | No | $0 | FL |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T1 | No | $0 | FL |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T1 | No | $0 | TX |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T1 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T1 | No | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T1 | No | $0 | TX |
| Prominence Beyond (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T1 | No | $0 | TX |
Frequently Asked Questions
Is icosapent ethyl 1000 MG Oral Capsule covered by Medicare Part D?
Yes, icosapent ethyl 1000 MG Oral Capsule is covered by 1,626 Medicare Part D plans (32.1% of all Part D formularies).
What tier is icosapent ethyl 1000 MG Oral Capsule on Medicare Part D plans?
icosapent ethyl 1000 MG Oral Capsule averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does icosapent ethyl 1000 MG Oral Capsule require prior authorization?
0.5% of Part D formularies require prior authorization for icosapent ethyl 1000 MG Oral Capsule. Step therapy: 0.5%. Quantity limits: 56.3%.
How much does Medicare spend on icosapent ethyl 1000 MG Oral Capsule?
In 2023, total Medicare Part D spending on icosapent ethyl 1000 MG Oral Capsule was $763,988,447, covering 279,946 beneficiaries. The average spend per beneficiary was $2,729.06.
Read our methodology - how this data is sourced, computed, and verified.