nitisinone 2 MG Oral Capsule [Orfadin]

Verify with CMS →

nitisinone

RxCUI: 352119

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.
0%
Plan Coverage
2
Plans Covering
T1
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for nitisinone 2 MG Oral Capsule [Orfadin]

Per the CMS 2026 Part D formulary file, nitisinone 2 MG Oral Capsule [Orfadin] (RxNorm concept RXCUI 352119, generic name nitisinone) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to nitisinone 2 MG Oral Capsule [Orfadin] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% 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 2 MG Oral Capsule [Orfadin] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

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

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering nitisinone 2 MG Oral Capsule [Orfadin]

2 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

Frequently Asked Questions

Is nitisinone 2 MG Oral Capsule [Orfadin] covered by Medicare Part D?

Yes, nitisinone 2 MG Oral Capsule [Orfadin] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is nitisinone 2 MG Oral Capsule [Orfadin] on Medicare Part D plans?

nitisinone 2 MG Oral Capsule [Orfadin] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does nitisinone 2 MG Oral Capsule [Orfadin] require prior authorization?

0% of Part D formularies require prior authorization for nitisinone 2 MG Oral Capsule [Orfadin]. Step therapy: 0%. Quantity limits: 0%.

Read our methodology - how this data is sourced, computed, and verified.

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