ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet
ledipasvir
RxCUI: 1591943
What the CMS Formulary Data Shows for ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet
Per the CMS 2026 Part D formulary file, ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet (RxNorm concept RXCUI 1591943, generic name ledipasvir) appears on 62 distinct formulary files spanning 855 Medicare Part D plan offerings - 16.9% 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 3.8.
Real-world access to ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 80.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 691 Part D beneficiaries filled ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet 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 90 MG / sofosbuvir 400 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 62
- Plans covering
- 855
- Coverage rate
- 16.9%
- 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
- 80.6% 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 90 MG / sofosbuvir 400 MG Oral Tablet
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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | Yes | $0 | MI |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | Yes | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN 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 |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | Yes | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | Yes | $15.20 | IL |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | Yes | $21.70 | NH |
| 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 |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | Yes | $36.20 | NC |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | Yes | $58.80 | NY |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
Frequently Asked Questions
Is ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet covered by Medicare Part D?
Yes, ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet is covered by 855 Medicare Part D plans (16.9% of all Part D formularies).
What tier is ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet on Medicare Part D plans?
ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet averages Tier 3.8 across Part D plans, ranging from Tier 1 to Tier 5.
Does ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet require prior authorization?
100% of Part D formularies require prior authorization for ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet. Step therapy: 0%. Quantity limits: 80.6%.
How much does Medicare spend on ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet?
In 2023, total Medicare Part D spending on ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet 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.