lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]

Verify with CMS →

lisdexamfetamine dimesylate

RxCUI: 1871459

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
0.2%
Plan Coverage
10
Plans Covering
T4
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]

Per the CMS 2026 Part D formulary file, lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] (RxNorm concept RXCUI 1871459, generic name lisdexamfetamine dimesylate) appears on 1 distinct formulary file spanning 10 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% 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 [Vyvanse] 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 [Vyvanse] today.

Coverage Details

Formularies covering
1
Plans covering
10
Coverage rate
0.2%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
57,529
Total spending
$138,990,768
Avg per beneficiary
$2,416.01

Tier Distribution Across Plans

10 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]

10 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $0 FL
Health First Value H1099-006 (HMO) HEALTH FIRST HEALTH PLANS T4 Yes $15.00 FL
Health First Classic H1099-001 (HMO-POS) HEALTH FIRST HEALTH PLANS T4 Yes $49.40 FL

Frequently Asked Questions

Is lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] covered by Medicare Part D?

Yes, lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).

What tier is lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] on Medicare Part D plans?

lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] require prior authorization?

100% of Part D formularies require prior authorization for lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]?

In 2023, total Medicare Part D spending on lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse] was $138,990,768, covering 57,529 beneficiaries. The average spend per beneficiary was $2,416.01.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial