perampanel 12 MG Oral Tablet [FYCOMPA]
perampanel
RxCUI: 1356588
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 12 MG Oral Tablet [FYCOMPA]
Per the CMS 2026 Part D formulary file, perampanel 12 MG Oral Tablet [FYCOMPA] (RxNorm concept RXCUI 1356588, 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 12 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. 75% 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 [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 12 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
- 75% 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 12 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 12 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 12 MG Oral Tablet [FYCOMPA] covered by Medicare Part D?
Yes, perampanel 12 MG Oral Tablet [FYCOMPA] is covered by 2,810 Medicare Part D plans (55.5% of all Part D formularies).
What tier is perampanel 12 MG Oral Tablet [FYCOMPA] on Medicare Part D plans?
perampanel 12 MG Oral Tablet [FYCOMPA] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does perampanel 12 MG Oral Tablet [FYCOMPA] require prior authorization?
61.1% of Part D formularies require prior authorization for perampanel 12 MG Oral Tablet [FYCOMPA]. Step therapy: 2.8%. Quantity limits: 75%.
How much does Medicare spend on perampanel 12 MG Oral Tablet [FYCOMPA]?
In 2023, total Medicare Part D spending on perampanel 12 MG Oral Tablet [FYCOMPA] 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.
Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial