lisdexamfetamine dimesylate 40 MG Chewable Tablet
lisdexamfetamine dimesylate
RxCUI: 1871456
What the CMS Formulary Data Shows for lisdexamfetamine dimesylate 40 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, lisdexamfetamine dimesylate 40 MG Chewable Tablet (RxNorm concept RXCUI 1871456, generic name lisdexamfetamine dimesylate) appears on 48 distinct formulary files spanning 2,201 Medicare Part D plan offerings - 43.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.7.
Real-world access to lisdexamfetamine dimesylate 40 MG Chewable Tablet depends on utilization management as much as tier placement: 27.1% of covering formularies require prior authorization. 0% require step therapy. 89.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 57,529 Part D beneficiaries filled lisdexamfetamine dimesylate 40 MG Chewable Tablet in 2023, with total plan-and-beneficiary spending of $138,990,768 and an average per-beneficiary annual cost of $2,416.01. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lisdexamfetamine dimesylate 40 MG Chewable Tablet today.
Coverage Details
- Formularies covering
- 48
- Plans covering
- 2,201
- Coverage rate
- 43.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 27.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 89.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 57,529
- Total spending
- $138,990,768
- Avg per beneficiary
- $2,416.01
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering lisdexamfetamine dimesylate 40 MG Chewable Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering lisdexamfetamine dimesylate 40 MG Chewable Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| 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 |
| DEVOTED CORE 001 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 002 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 003 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 005 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 013 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 014 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 015 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 018 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 025 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 027 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 029 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 031 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 032 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 035 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 036 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 045 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 046 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 049 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 050 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED GIVEBACK 051 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $0 | FL |
| DEVOTED CORE 001 AZ (HMO) | DEVOTED HEALTH PLAN OF ARIZONA, INC. | T2 | Yes | $0 | AZ |
| DEVOTED C-SNP 011 AZ (HMO C-SNP) | DEVOTED HEALTH PLAN OF ARIZONA, INC. | T2 | Yes | $0 | AZ |
| DEVOTED PREMIUM 037 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $4.80 | FL |
| DEVOTED PREMIUM 044 FL (HMO) | DEVOTED HEALTH PLAN OF FLORIDA, INC. | T2 | Yes | $4.80 | FL |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $0 | WI |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $21.10 | WI |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $38.60 | WI |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | No | $92.80 | WI |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T4 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T4 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | UNITEDHEALTHCARE INSURANCE COMPANY | T4 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | UNITEDHEALTHCARE INSURANCE COMPANY | T4 | No | $0 | NM |
Frequently Asked Questions
Is lisdexamfetamine dimesylate 40 MG Chewable Tablet covered by Medicare Part D?
Yes, lisdexamfetamine dimesylate 40 MG Chewable Tablet is covered by 2,201 Medicare Part D plans (43.4% of all Part D formularies).
What tier is lisdexamfetamine dimesylate 40 MG Chewable Tablet on Medicare Part D plans?
lisdexamfetamine dimesylate 40 MG Chewable Tablet averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does lisdexamfetamine dimesylate 40 MG Chewable Tablet require prior authorization?
27.1% of Part D formularies require prior authorization for lisdexamfetamine dimesylate 40 MG Chewable Tablet. Step therapy: 0%. Quantity limits: 89.6%.
How much does Medicare spend on lisdexamfetamine dimesylate 40 MG Chewable Tablet?
In 2023, total Medicare Part D spending on lisdexamfetamine dimesylate 40 MG Chewable Tablet was $138,990,768, covering 57,529 beneficiaries. The average spend per beneficiary was $2,416.01.
Read our methodology - how this data is sourced, computed, and verified.