Medicare Part D coverage · latanoprostene bunod · RxCUI 1988399
latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta]
Per the CMS 2026 Part D formulary file, latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] is covered by 3,995 Medicare Part D plans (79.1% of enrollable products), averaging Tier 3.5, with prior authorization required on 0.6% of covering formularies.
- 79.1%
- Plan coverage
- 3,995
- Plans covering
- T3.5
- Avg tier
- 0.6%
- Prior auth required
What the CMS Formulary Data Shows for latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta]
Per the CMS 2026 Part D formulary file, latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] (RxNorm concept RXCUI 1988399, generic name latanoprostene bunod) appears on 179 distinct formulary files spanning 3,995 Medicare Part D plan offerings - 79.1% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.5.
Real-world access to latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] depends on utilization management as much as tier placement: 0.6% of covering formularies require prior authorization. 1.7% require step therapy. 44.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 69,308 Part D beneficiaries filled latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] in 2023, with total plan-and-beneficiary spending of $117,369,728 and an average per-beneficiary annual cost of $1,693.45. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] today.
Coverage Details
- Formularies covering
- 179
- Plans covering
- 3,995
- Coverage rate
- 79.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0.6% of formularies
- Step therapy required
- 1.7% of formularies
- Quantity limits
- 44.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 69,308
- Total spending
- $117,369,728
- Avg per beneficiary
- $1,693.45
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| 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 |
Show the next 30 plans
| 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 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 |
| 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 |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] covered by Medicare Part D?
Yes, latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] is covered by 3,995 Medicare Part D plans (79.1% of all Part D formularies).
What tier is latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] on Medicare Part D plans?
latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] require prior authorization?
0.6% of Part D formularies require prior authorization for latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta]. Step therapy: 1.7%. Quantity limits: 44.1%.
How much does Medicare spend on latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta]?
In 2023, total Medicare Part D spending on latanoprostene bunod 0.24 MG/ML Ophthalmic Solution [Vyzulta] was $117,369,728, covering 69,308 beneficiaries. The average spend per beneficiary was $1,693.45.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.24 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 1.4 MG/ML / lysine 1.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / sodium acetate 0.097 MEQ/ML / sodium chloride 0.003 MEQ/ML / sodium metabisulfite 0.5 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.84 MG/ML / valine 7.8 MG/ML Injectable Solution [Trophamine 10 %] T3.5
- fezolinetant 45 MG Oral Tablet [Veozah] T3.5
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / sodium acetate trihydrate 2.97 MG/ML / sodium chloride 0.013 MEQ/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix E 4.25/5] T3.5
- amoxicillin 25 MG/ML / clavulanate 6.25 MG/ML Oral Suspension [Augmentin] T3.5
- {2 (480 ML) (magnesium sulfate 0.0277 MEQ/ML / potassium sulfate 0.0374 MEQ/ML / sodium sulfate 0.257 MEQ/ML Oral Solution) } Pack [Suprep Bowel Prep Kit] T3.5
- canagliflozin 100 MG Oral Tablet [Invokana] T3.5
Similar prior-authorization rate
- Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] 0.6% PA
- 0.8 ML chikungunya virus antigen, recombinant Senegal strain 37997 0.05 MG/ML Prefilled Syringe [Vimkunya] 0.6% PA
- etonogestrel 68 MG Drug Implant [Nexplanon] 0.6% PA
- 3 ML insulin lispro 50 UNT/ML / insulin lispro protamine, human 50 UNT/ML Pen Injector [Humalog Mix] 0.6% PA
- insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Injectable Suspension [Humalog Mix] 0.6% PA
- 3 ML insulin lispro 25 UNT/ML / insulin lispro protamine, human 75 UNT/ML Pen Injector [Humalog Mix] 0.6% PA