lenalidomide 25 MG Oral Capsule [Revlimid]
lenalidomide
RxCUI: 643722
What the CMS Formulary Data Shows for lenalidomide 25 MG Oral Capsule [Revlimid]
Per the CMS 2026 Part D formulary file, lenalidomide 25 MG Oral Capsule [Revlimid] (RxNorm concept RXCUI 643722, generic name lenalidomide) appears on 15 distinct formulary files spanning 176 Medicare Part D plan offerings - 3.5% 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 4.5.
Real-world access to lenalidomide 25 MG Oral Capsule [Revlimid] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 73.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 36,967 Part D beneficiaries filled lenalidomide 25 MG Oral Capsule [Revlimid] in 2023, with total plan-and-beneficiary spending of $3,859,804,789 and an average per-beneficiary annual cost of $104,412.17. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lenalidomide 25 MG Oral Capsule [Revlimid] today.
Coverage Details
- Formularies covering
- 15
- Plans covering
- 176
- Coverage rate
- 3.5%
- 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
- 73.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 36,967
- Total spending
- $3,859,804,789
- Avg per beneficiary
- $104,412.17
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lenalidomide 25 MG Oral Capsule [Revlimid]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MO |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MO |
| HealthSpring Premier (HMO-POS) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | UT |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | NM |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | OH |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred Savings (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | OH |
| HealthSpring Preferred Savings (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred (HMO) | CIGNA HEALTHCARE OF COLORADO, INC. | T5 | Yes | $0 | CO |
| HealthSpring Preferred (HMO) | BRAVO HEALTH MID-ATLANTIC, INC. | T5 | Yes | $0 | DC, DE |
| HealthSpring Preferred PA (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T5 | Yes | $0 | NJ |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MS |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | WA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | OR, WA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | TX |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | TN |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | MS, TN |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | TX |
| HealthSpring Alliance (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | TX |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | GA, TN |
| HealthSpring Preferred Savings (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T5 | Yes | $0 | OK |
Frequently Asked Questions
Is lenalidomide 25 MG Oral Capsule [Revlimid] covered by Medicare Part D?
Yes, lenalidomide 25 MG Oral Capsule [Revlimid] is covered by 176 Medicare Part D plans (3.5% of all Part D formularies).
What tier is lenalidomide 25 MG Oral Capsule [Revlimid] on Medicare Part D plans?
lenalidomide 25 MG Oral Capsule [Revlimid] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.
Does lenalidomide 25 MG Oral Capsule [Revlimid] require prior authorization?
100% of Part D formularies require prior authorization for lenalidomide 25 MG Oral Capsule [Revlimid]. Step therapy: 0%. Quantity limits: 73.3%.
How much does Medicare spend on lenalidomide 25 MG Oral Capsule [Revlimid]?
In 2023, total Medicare Part D spending on lenalidomide 25 MG Oral Capsule [Revlimid] was $3,859,804,789, covering 36,967 beneficiaries. The average spend per beneficiary was $104,412.17.
Read our methodology - how this data is sourced, computed, and verified.