ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]
ledipasvir
RxCUI: 2204102
What the CMS Formulary Data Shows for ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]
Per the CMS 2026 Part D formulary file, ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] (RxNorm concept RXCUI 2204102, generic name ledipasvir) appears on 72 distinct formulary files spanning 779 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 33.75 MG / sofosbuvir 150 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 33.75 MG / sofosbuvir 150 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 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] today.
Coverage Details
- Formularies covering
- 72
- Plans covering
- 779
- 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
Standalone Drug Plans (PDP) Covering ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Anthem Full Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T5 | Yes | No | $0 | CT |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T5 | Yes | No | $0 | CT |
| Anthem Kidney Care (HMO-POS C-SNP) | ANTHEM HEALTH PLANS, INC. | T5 | Yes | No | $0 | CT |
| Anthem Full Dual Advantage Select (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T5 | Yes | No | $0 | CT |
| Anthem Dual Advantage (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T5 | Yes | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]
95 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 |
| 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 |
Frequently Asked Questions
Is ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] covered by Medicare Part D?
Yes, ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] is covered by 779 Medicare Part D plans (15.4% of all Part D formularies).
What tier is ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] on Medicare Part D plans?
ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni] require prior authorization?
100% of Part D formularies require prior authorization for ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]. Step therapy: 0%. Quantity limits: 95.8%.
How much does Medicare spend on ledipasvir 33.75 MG / sofosbuvir 150 MG Oral Pellet [Harvoni]?
In 2023, total Medicare Part D spending on ledipasvir 33.75 MG / sofosbuvir 150 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.