insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra]
insulin glulisine, human
RxCUI: 803194
What the CMS Formulary Data Shows for insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra]
Per the CMS 2026 Part D formulary file, insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] (RxNorm concept RXCUI 803194, generic name insulin glulisine, human) 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 4, with a cross-plan average of Tier 2.5.
Real-world access to insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] 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 418,431 Part D beneficiaries filled insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] in 2023, with total plan-and-beneficiary spending of $1,208,385,334 and an average per-beneficiary annual cost of $2,887.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 10
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 4
- 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
- 418,431
- Total spending
- $1,208,385,334
- Avg per beneficiary
- $2,887.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra]
10 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $0 | WI |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $21.10 | WI |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $38.60 | WI |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | Yes | $92.80 | WI |
Frequently Asked Questions
Is insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] covered by Medicare Part D?
Yes, insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).
What tier is insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] on Medicare Part D plans?
insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] require prior authorization?
100% of Part D formularies require prior authorization for insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra]?
In 2023, total Medicare Part D spending on insulin glulisine, human 100 UNT/ML Injectable Solution [Apidra] was $1,208,385,334, covering 418,431 beneficiaries. The average spend per beneficiary was $2,887.90.
Read our methodology - how this data is sourced, computed, and verified.