Medicare Part D coverage · ledipasvir · RxCUI 2204104
ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni]
Per the CMS 2026 Part D formulary file, ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] is covered by 778 Medicare Part D plans (15.4% of enrollable products), averaging Tier 4.2, with prior authorization required on 100% of covering formularies.
- 15.4%
- Plan coverage
- 778
- Plans covering
- T4.2
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni]
Per the CMS 2026 Part D formulary file, ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] (RxNorm concept RXCUI 2204104, generic name ledipasvir) appears on 72 distinct formulary files spanning 778 Medicare Part D plan offerings - 15.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 95.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 691 Part D beneficiaries filled ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] in 2023, with total plan-and-beneficiary spending of $54,963,199 and an average per-beneficiary annual cost of $79,541.53. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] today.
Coverage Details
- Formularies covering
- 72
- Plans covering
- 778
- Coverage rate
- 15.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 95.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 691
- Total spending
- $54,963,199
- Avg per beneficiary
- $79,541.53
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $35.90 | KY, TN |
Show the next 30 plans
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $58.80 | NY |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T4 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T4 | Yes | $0 | NY |
| Leon MediExtra (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T4 | Yes | $51.60 | NY |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T5 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T5 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T5 | Yes | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T5 | Yes | $0 | CA |
| Anthem Full Dual Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T5 | Yes | $0 | IN |
| Anthem I PathWays Dual Care Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T5 | Yes | $0 | IN |
| Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) | Anthem Insurance Companies, Inc. | T5 | Yes | $0 | IN |
| Wellpoint Full Dual Advantage (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T5 | Yes | $0 | IA |
| Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T5 | Yes | $0 | IA |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint West Virginia , Inc. | T5 | Yes | $0 | WV |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T5 | Yes | $0 | WA |
| Wellpoint Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T5 | Yes | $0 | WA |
| Healthy Blue Dual Advantage (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T5 | Yes | $0 | LA |
| Healthy Blue Dual Advantage 2 (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T5 | Yes | $0 | LA |
| Anthem Dual Advantage (PPO D-SNP) | Anthem Insurance Companies, Inc. | T5 | Yes | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Texas, Inc. | T5 | Yes | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | Wellpoint Texas, Inc. | T5 | Yes | $0 | TX |
| Wellpoint Dual Advantage 2 (HMO D-SNP) | Wellpoint Texas, Inc. | T5 | Yes | $0 | TX |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] covered by Medicare Part D?
Yes, ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] is covered by 778 Medicare Part D plans (15.4% of all Part D formularies).
What tier is ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] on Medicare Part D plans?
ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] require prior authorization?
100% of Part D formularies require prior authorization for ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni]. Step therapy: 0%. Quantity limits: 95.8%.
How much does Medicare spend on ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni]?
In 2023, total Medicare Part D spending on ledipasvir 45 MG / sofosbuvir 200 MG Oral Pellet [Harvoni] was $54,963,199, covering 691 beneficiaries. The average spend per beneficiary was $79,541.53.
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
- 1.5 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 2 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 24 HR asenapine 0.158 MG/HR Transdermal System [Secuado] T4.2
- aripiprazole 400 MG Injection [Abilify] T4.2
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex] T4.2
- naltrexone 380 MG Injection [Vivitrol] T4.2
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA