Once-Daily gabapentin 450 MG Oral Tablet [Gralise]
Once-Daily gabapentin
RxCUI: 2634749
What the CMS Formulary Data Shows for Once-Daily gabapentin 450 MG Oral Tablet [Gralise]
Per the CMS 2026 Part D formulary file, Once-Daily gabapentin 450 MG Oral Tablet [Gralise] (RxNorm concept RXCUI 2634749, generic name Once-Daily gabapentin) appears on 1 distinct formulary file spanning 10 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to Once-Daily gabapentin 450 MG Oral Tablet [Gralise] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,259 Part D beneficiaries filled Once-Daily gabapentin 450 MG Oral Tablet [Gralise] in 2023, with total plan-and-beneficiary spending of $23,008,454 and an average per-beneficiary annual cost of $5,402.31. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry Once-Daily gabapentin 450 MG Oral Tablet [Gralise] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 10
- Coverage rate
- 0.2%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,259
- Total spending
- $23,008,454
- Avg per beneficiary
- $5,402.31
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering Once-Daily gabapentin 450 MG Oral Tablet [Gralise]
10 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Health First Rewards H1099-014 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $0 | FL |
| Health First Value H1099-006 (HMO) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $15.00 | FL |
| Health First Classic H1099-001 (HMO-POS) | HEALTH FIRST HEALTH PLANS | T4 | Yes | $49.40 | FL |
Frequently Asked Questions
Is Once-Daily gabapentin 450 MG Oral Tablet [Gralise] covered by Medicare Part D?
Yes, Once-Daily gabapentin 450 MG Oral Tablet [Gralise] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).
What tier is Once-Daily gabapentin 450 MG Oral Tablet [Gralise] on Medicare Part D plans?
Once-Daily gabapentin 450 MG Oral Tablet [Gralise] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does Once-Daily gabapentin 450 MG Oral Tablet [Gralise] require prior authorization?
100% of Part D formularies require prior authorization for Once-Daily gabapentin 450 MG Oral Tablet [Gralise]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on Once-Daily gabapentin 450 MG Oral Tablet [Gralise]?
In 2023, total Medicare Part D spending on Once-Daily gabapentin 450 MG Oral Tablet [Gralise] was $23,008,454, covering 4,259 beneficiaries. The average spend per beneficiary was $5,402.31.
Read our methodology - how this data is sourced, computed, and verified.