nitisinone 5 MG Oral Tablet [Nityr]

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nitisinone

RxCUI: 1941473

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.
2.8%
Plan Coverage
143
Plans Covering
T4.7
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for nitisinone 5 MG Oral Tablet [Nityr]

Per the CMS 2026 Part D formulary file, nitisinone 5 MG Oral Tablet [Nityr] (RxNorm concept RXCUI 1941473, generic name nitisinone) appears on 18 distinct formulary files spanning 143 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.7.

Real-world access to nitisinone 5 MG Oral Tablet [Nityr] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 11.1% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nitisinone 5 MG Oral Tablet [Nityr] today.

Coverage Details

Formularies covering
18
Plans covering
143
Coverage rate
2.8%
Tier range
Tier 1 – Tier 6
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
11.1% of formularies

Tier Distribution Across Plans

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

Medicare Advantage Plans (MA-PD) Covering nitisinone 5 MG Oral Tablet [Nityr]

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

Plan Insurer Tier PA Premium States
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
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
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 CO

Frequently Asked Questions

Is nitisinone 5 MG Oral Tablet [Nityr] covered by Medicare Part D?

Yes, nitisinone 5 MG Oral Tablet [Nityr] is covered by 143 Medicare Part D plans (2.8% of all Part D formularies).

What tier is nitisinone 5 MG Oral Tablet [Nityr] on Medicare Part D plans?

nitisinone 5 MG Oral Tablet [Nityr] averages Tier 4.7 across Part D plans, ranging from Tier 1 to Tier 6.

Does nitisinone 5 MG Oral Tablet [Nityr] require prior authorization?

100% of Part D formularies require prior authorization for nitisinone 5 MG Oral Tablet [Nityr]. Step therapy: 0%. Quantity limits: 11.1%.

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