Medicare Part D coverage · perampanel · RxCUI 1356586
perampanel 12 MG Oral Tablet
Per the CMS 2026 Part D formulary file, perampanel 12 MG Oral Tablet is covered by 4,243 Medicare Part D plans (84% of enrollable products), averaging Tier 3.8, with prior authorization required on 39.6% of covering formularies.
- 84%
- Plan coverage
- 4,243
- Plans covering
- T3.8
- Avg tier
- 39.6%
- Prior auth required
What the CMS Formulary Data Shows for perampanel 12 MG Oral Tablet
Per the CMS 2026 Part D formulary file, perampanel 12 MG Oral Tablet (RxNorm concept RXCUI 1356586, generic name perampanel) appears on 323 distinct formulary files spanning 4,243 Medicare Part D plan offerings - 84% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.8.
Real-world access to perampanel 12 MG Oral Tablet depends on utilization management as much as tier placement: 39.6% of covering formularies require prior authorization. 21.4% require step therapy. 87.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,343 Part D beneficiaries filled perampanel 12 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $72,036,496 and an average per-beneficiary annual cost of $11,356.85. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry perampanel 12 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 323
- Plans covering
- 4,243
- Coverage rate
- 84%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 39.6% of formularies
- Step therapy required
- 21.4% of formularies
- Quantity limits
- 87.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,343
- Total spending
- $72,036,496
- Avg per beneficiary
- $11,356.85
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering perampanel 12 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is perampanel 12 MG Oral Tablet covered by Medicare Part D?
Yes, perampanel 12 MG Oral Tablet is covered by 4,243 Medicare Part D plans (84% of all Part D formularies).
What tier is perampanel 12 MG Oral Tablet on Medicare Part D plans?
perampanel 12 MG Oral Tablet averages Tier 3.8 across Part D plans, ranging from Tier 1 to Tier 6.
Does perampanel 12 MG Oral Tablet require prior authorization?
39.6% of Part D formularies require prior authorization for perampanel 12 MG Oral Tablet. Step therapy: 21.4%. Quantity limits: 87.9%.
How much does Medicare spend on perampanel 12 MG Oral Tablet?
In 2023, total Medicare Part D spending on perampanel 12 MG Oral Tablet was $72,036,496, covering 6,343 beneficiaries. The average spend per beneficiary was $11,356.85.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- etravirine 100 MG Oral Tablet T3.8
- risperidone 37.5 MG Injection T3.8
- lamotrigine 10 MG/ML Oral Suspension [Subvenite] T3.8
- {7 (sodium oxybate 4500 MG Granules for Oral Suspension [Lumryz]) / 14 (sodium oxybate 6000 MG Granules for Oral Suspension [Lumryz]) / 7 (sodium oxybate 7500 MG Granules for Oral Suspension [Lumryz]) } Pack [Lumryz 28-Day Starter Pack] T3.8
- loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] T3.8
- carbidopa 4.63 MG/ML / levodopa 20 MG/ML Oral Suspension [Duopa] T3.8
Similar prior-authorization rate
- tiopronin 100 MG Oral Tablet 39.4% PA
- flucytosine 500 MG Oral Capsule 39.9% PA
- 0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Vabrinty] 40% PA
- tapinarof 10 MG/ML Topical Cream [Vtama] 40% PA
- dexmethylphenidate hydrochloride 5 MG Oral Tablet 39.1% PA
- dexmethylphenidate hydrochloride 10 MG Oral Tablet 39.1% PA