methotrexate 5 MG Oral Tablet [Trexall]
methotrexate
RxCUI: 284592
What the CMS Formulary Data Shows for methotrexate 5 MG Oral Tablet [Trexall]
Per the CMS 2026 Part D formulary file, methotrexate 5 MG Oral Tablet [Trexall] (RxNorm concept RXCUI 284592, generic name methotrexate) appears on 12 distinct formulary files spanning 169 Medicare Part D plan offerings - 3.3% 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 2.9.
Real-world access to methotrexate 5 MG Oral Tablet [Trexall] depends on utilization management as much as tier placement: 25% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 84 Part D beneficiaries filled methotrexate 5 MG Oral Tablet [Trexall] in 2023, with total plan-and-beneficiary spending of $248,445 and an average per-beneficiary annual cost of $2,957.68. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methotrexate 5 MG Oral Tablet [Trexall] today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 169
- Coverage rate
- 3.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 25% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 84
- Total spending
- $248,445
- Avg per beneficiary
- $2,957.68
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methotrexate 5 MG Oral Tablet [Trexall]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is methotrexate 5 MG Oral Tablet [Trexall] covered by Medicare Part D?
Yes, methotrexate 5 MG Oral Tablet [Trexall] is covered by 169 Medicare Part D plans (3.3% of all Part D formularies).
What tier is methotrexate 5 MG Oral Tablet [Trexall] on Medicare Part D plans?
methotrexate 5 MG Oral Tablet [Trexall] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does methotrexate 5 MG Oral Tablet [Trexall] require prior authorization?
25% of Part D formularies require prior authorization for methotrexate 5 MG Oral Tablet [Trexall]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on methotrexate 5 MG Oral Tablet [Trexall]?
In 2023, total Medicare Part D spending on methotrexate 5 MG Oral Tablet [Trexall] was $248,445, covering 84 beneficiaries. The average spend per beneficiary was $2,957.68.
Read our methodology - how this data is sourced, computed, and verified.