prucalopride 1 MG Oral Tablet
prucalopride
RxCUI: 2107345
What the CMS Formulary Data Shows for prucalopride 1 MG Oral Tablet
Per the CMS 2026 Part D formulary file, prucalopride 1 MG Oral Tablet (RxNorm concept RXCUI 2107345, generic name prucalopride) appears on 26 distinct formulary files spanning 158 Medicare Part D plan offerings - 3.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.
Real-world access to prucalopride 1 MG Oral Tablet depends on utilization management as much as tier placement: 3.8% of covering formularies require prior authorization. 7.7% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 19,413 Part D beneficiaries filled prucalopride 1 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $61,916,752 and an average per-beneficiary annual cost of $3,189.45. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry prucalopride 1 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 26
- Plans covering
- 158
- Coverage rate
- 3.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 3.8% of formularies
- Step therapy required
- 7.7% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 19,413
- Total spending
- $61,916,752
- Avg per beneficiary
- $3,189.45
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering prucalopride 1 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| 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 |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | No | $15.20 | IL |
| 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 |
| 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 |
| 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 |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T2 | Yes | $0 | OR |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $21.10 | WI |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $38.60 | WI |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $92.80 | WI |
| eternalHealth Forever (HMO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Freedom (PPO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Give Back (PPO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Horizon (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| eternalHealth Grand Give Back (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| eternalHealth + Fry's Medicare Advantage (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| Senior Care Plus Essential plan (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Complete Plan (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Renown Preferred Plan by Senior Care Plus (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Extensive Duals Plan (HMO D-SNP) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Enriched Duals Plan (HMO D-SNP) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| MyAdvocate Medicare Advantage SILVER (HMO-POS) | BESHP, INC. | T3 | No | $0 | NE |
| Great Plain Medicare Advantage Gold (HMO I-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | IA, SD |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN OF MINNESOTA | T3 | No | $0 | MN |
| Great Plains Medicare Advantage Gold (HMO I-SNP) | GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC. | T3 | No | $0 | NE |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN | T3 | No | $0 | IA, SD |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Great Plains Medicare Advantage Gold (HMO I-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Align Dual Partnership (HMO D-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Ally Rx (HMO D-SNP) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | T3 | No | $0 | WI |
| Esteem Rx (HMO-POS) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | T3 | No | $0 | WI |
Frequently Asked Questions
Is prucalopride 1 MG Oral Tablet covered by Medicare Part D?
Yes, prucalopride 1 MG Oral Tablet is covered by 158 Medicare Part D plans (3.1% of all Part D formularies).
What tier is prucalopride 1 MG Oral Tablet on Medicare Part D plans?
prucalopride 1 MG Oral Tablet averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does prucalopride 1 MG Oral Tablet require prior authorization?
3.8% of Part D formularies require prior authorization for prucalopride 1 MG Oral Tablet. Step therapy: 7.7%. Quantity limits: 100%.
How much does Medicare spend on prucalopride 1 MG Oral Tablet?
In 2023, total Medicare Part D spending on prucalopride 1 MG Oral Tablet was $61,916,752, covering 19,413 beneficiaries. The average spend per beneficiary was $3,189.45.
Read our methodology - how this data is sourced, computed, and verified.