perampanel 4 MG Oral Tablet [FYCOMPA]

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perampanel

RxCUI: 1356572

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.
55.5%
Plan Coverage
2,810
Plans Covering
T4.3
Avg Tier
61.1%
Prior Auth Required

What the CMS Formulary Data Shows for perampanel 4 MG Oral Tablet [FYCOMPA]

Per the CMS 2026 Part D formulary file, perampanel 4 MG Oral Tablet [FYCOMPA] (RxNorm concept RXCUI 1356572, generic name perampanel) appears on 108 distinct formulary files spanning 2,810 Medicare Part D plan offerings - 55.5% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.3.

Real-world access to perampanel 4 MG Oral Tablet [FYCOMPA] depends on utilization management as much as tier placement: 61.1% of covering formularies require prior authorization. 2.8% require step therapy. 77.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,343 Part D beneficiaries filled perampanel 4 MG Oral Tablet [FYCOMPA] 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 4 MG Oral Tablet [FYCOMPA] today.

Coverage Details

Formularies covering
108
Plans covering
2,810
Coverage rate
55.5%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
61.1% of formularies
Step therapy required
2.8% of formularies
Quantity limits
77.8% of formularies

2023 Medicare Spending

Beneficiaries
6,343
Total spending
$72,036,496
Avg per beneficiary
$11,356.85

Tier Distribution Across Plans

54 plans
Tier 1, Preferred Generic
46 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering perampanel 4 MG Oral Tablet [FYCOMPA]

33 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T4 Yes No $0 -
CarePartners Access (PPO) CAREPARTNERS OF CONNECTICUT, INC. T4 No No $0 CT
CarePartners of CT CareAdvantage Preferred (HMO) CAREPARTNERS OF CONNECTICUT, INC. T4 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering perampanel 4 MG Oral Tablet [FYCOMPA]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
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
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
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
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
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 Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 No $4.80 TX
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 No $15.20 IL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
Provider Partners Maryland Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
Provider Partners Maryland Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $32.70 PA
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
Provider Partners North Carolina Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY T1 No $38.40 KY

Frequently Asked Questions

Is perampanel 4 MG Oral Tablet [FYCOMPA] covered by Medicare Part D?

Yes, perampanel 4 MG Oral Tablet [FYCOMPA] is covered by 2,810 Medicare Part D plans (55.5% of all Part D formularies).

What tier is perampanel 4 MG Oral Tablet [FYCOMPA] on Medicare Part D plans?

perampanel 4 MG Oral Tablet [FYCOMPA] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.

Does perampanel 4 MG Oral Tablet [FYCOMPA] require prior authorization?

61.1% of Part D formularies require prior authorization for perampanel 4 MG Oral Tablet [FYCOMPA]. Step therapy: 2.8%. Quantity limits: 77.8%.

How much does Medicare spend on perampanel 4 MG Oral Tablet [FYCOMPA]?

In 2023, total Medicare Part D spending on perampanel 4 MG Oral Tablet [FYCOMPA] was $72,036,496, covering 6,343 beneficiaries. The average spend per beneficiary was $11,356.85.

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