Medicare Part D coverage · mercaptopurine · RxCUI 1536490
mercaptopurine 20 MG/ML Oral Suspension [Purixan]
Per the CMS 2026 Part D formulary file, mercaptopurine 20 MG/ML Oral Suspension [Purixan] is covered by 1,922 Medicare Part D plans (38% of enrollable products), averaging Tier 4.8, with prior authorization required on 28.1% of covering formularies.
- 38%
- 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 - 38% 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
- 38%
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 (38% 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.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- prednisone 1 MG Delayed Release Oral Tablet T4.8
- eltrombopag 25 MG Powder for Oral Suspension [Promacta] T4.8
- selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] T4.8
- 0.4 ML adalimumab-adbm 100 MG/ML Prefilled Syringe T4.8
- emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] T4.8
- eltrombopag 25 MG Oral Tablet [Promacta] T4.8
Similar prior-authorization rate
- insulin aspart, human 100 UNT/ML Injectable Solution [NovoLog] 28% PA
- levocarnitine 330 MG Oral Tablet 27.9% PA
- tedizolid phosphate 200 MG Injection [Sivextro] 27.9% PA
- levocarnitine 100 MG/ML Oral Solution 28.4% PA
- dexamethasone 20 MG Oral Tablet [Hemady] 27.8% PA
- collagenase 0.25 UNT/MG Topical Ointment [Santyl] 27.8% PA