mesalamine 250 MG Extended Release Oral Capsule [Pentasa]
mesalamine
RxCUI: 206791
What the CMS Formulary Data Shows for mesalamine 250 MG Extended Release Oral Capsule [Pentasa]
Per the CMS 2026 Part D formulary file, mesalamine 250 MG Extended Release Oral Capsule [Pentasa] (RxNorm concept RXCUI 206791, generic name mesalamine) appears on 35 distinct formulary files spanning 1,119 Medicare Part D plan offerings - 22.1% 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 3.4.
Real-world access to mesalamine 250 MG Extended Release Oral Capsule [Pentasa] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 71.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 95,185 Part D beneficiaries filled mesalamine 250 MG Extended Release Oral Capsule [Pentasa] in 2023, with total plan-and-beneficiary spending of $271,604,425 and an average per-beneficiary annual cost of $2,853.44. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mesalamine 250 MG Extended Release Oral Capsule [Pentasa] today.
Coverage Details
- Formularies covering
- 35
- Plans covering
- 1,119
- Coverage rate
- 22.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 71.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 95,185
- Total spending
- $271,604,425
- Avg per beneficiary
- $2,853.44
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering mesalamine 250 MG Extended Release Oral Capsule [Pentasa]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is mesalamine 250 MG Extended Release Oral Capsule [Pentasa] covered by Medicare Part D?
Yes, mesalamine 250 MG Extended Release Oral Capsule [Pentasa] is covered by 1,119 Medicare Part D plans (22.1% of all Part D formularies).
What tier is mesalamine 250 MG Extended Release Oral Capsule [Pentasa] on Medicare Part D plans?
mesalamine 250 MG Extended Release Oral Capsule [Pentasa] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does mesalamine 250 MG Extended Release Oral Capsule [Pentasa] require prior authorization?
0% of Part D formularies require prior authorization for mesalamine 250 MG Extended Release Oral Capsule [Pentasa]. Step therapy: 0%. Quantity limits: 71.4%.
How much does Medicare spend on mesalamine 250 MG Extended Release Oral Capsule [Pentasa]?
In 2023, total Medicare Part D spending on mesalamine 250 MG Extended Release Oral Capsule [Pentasa] was $271,604,425, covering 95,185 beneficiaries. The average spend per beneficiary was $2,853.44.
Read our methodology - how this data is sourced, computed, and verified.