mercaptopurine 20 MG/ML Oral Suspension [Purixan]

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mercaptopurine

RxCUI: 1536490

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.
37.9%
Plan Coverage
1,922
Plans Covering
T4.8
Avg Tier
28.1%
Prior Auth Required

What the CMS Formulary Data Shows for mercaptopurine 20 MG/ML Oral Suspension [Purixan]

Per the CMS 2026 Part D formulary file, mercaptopurine 20 MG/ML Oral Suspension [Purixan] (RxNorm concept RXCUI 1536490, generic name mercaptopurine) appears on 32 distinct formulary files spanning 1,922 Medicare Part D plan offerings - 37.9% 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 4.8.

Real-world access to mercaptopurine 20 MG/ML Oral Suspension [Purixan] depends on utilization management as much as tier placement: 28.1% of covering formularies require prior authorization. 0% require step therapy. 3.1% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 10,603 Part D beneficiaries filled mercaptopurine 20 MG/ML Oral Suspension [Purixan] in 2023, with total plan-and-beneficiary spending of $5,735,426 and an average per-beneficiary annual cost of $540.92. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mercaptopurine 20 MG/ML Oral Suspension [Purixan] today.

Coverage Details

Formularies covering
32
Plans covering
1,922
Coverage rate
37.9%
Tier range
Tier 1 – Tier 5
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
28.1% of formularies
Step therapy required
0% of formularies
Quantity limits
3.1% of formularies

2023 Medicare Spending

Beneficiaries
10,603
Total spending
$5,735,426
Avg per beneficiary
$540.92

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
39 plans
Tier 4, Non-Preferred
59 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering mercaptopurine 20 MG/ML Oral Suspension [Purixan]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 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
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 Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T4 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T4 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T4 Yes $0 FL
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T5 No $0 CA

Frequently Asked Questions

Is mercaptopurine 20 MG/ML Oral Suspension [Purixan] covered by Medicare Part D?

Yes, mercaptopurine 20 MG/ML Oral Suspension [Purixan] is covered by 1,922 Medicare Part D plans (37.9% of all Part D formularies).

What tier is mercaptopurine 20 MG/ML Oral Suspension [Purixan] on Medicare Part D plans?

mercaptopurine 20 MG/ML Oral Suspension [Purixan] averages Tier 4.8 across Part D plans, ranging from Tier 1 to Tier 5.

Does mercaptopurine 20 MG/ML Oral Suspension [Purixan] require prior authorization?

28.1% of Part D formularies require prior authorization for mercaptopurine 20 MG/ML Oral Suspension [Purixan]. Step therapy: 0%. Quantity limits: 3.1%.

How much does Medicare spend on mercaptopurine 20 MG/ML Oral Suspension [Purixan]?

In 2023, total Medicare Part D spending on mercaptopurine 20 MG/ML Oral Suspension [Purixan] was $5,735,426, covering 10,603 beneficiaries. The average spend per beneficiary was $540.92.

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