risperidone 37.5 MG Injection [Risperdal]
risperidone
RxCUI: 706827
What the CMS Formulary Data Shows for risperidone 37.5 MG Injection [Risperdal]
Per the CMS 2026 Part D formulary file, risperidone 37.5 MG Injection [Risperdal] (RxNorm concept RXCUI 706827, generic name risperidone) appears on 24 distinct formulary files spanning 1,341 Medicare Part D plan offerings - 26.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.5.
Real-world access to risperidone 37.5 MG Injection [Risperdal] depends on utilization management as much as tier placement: 4.2% of covering formularies require prior authorization. 8.3% require step therapy. 83.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 478,904 Part D beneficiaries filled risperidone 37.5 MG Injection [Risperdal] in 2023, with total plan-and-beneficiary spending of $60,762,995 and an average per-beneficiary annual cost of $126.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry risperidone 37.5 MG Injection [Risperdal] today.
Coverage Details
- Formularies covering
- 24
- Plans covering
- 1,341
- Coverage rate
- 26.5%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 4.2% of formularies
- Step therapy required
- 8.3% of formularies
- Quantity limits
- 83.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 478,904
- Total spending
- $60,762,995
- Avg per beneficiary
- $126.88
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering risperidone 37.5 MG Injection [Risperdal]
94 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $0.40 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $2.50 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $4.30 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $4.40 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $4.70 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $6.60 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $6.80 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $8.40 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $9.90 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $10.10 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $10.60 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $15.50 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $16.50 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $19.30 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $19.40 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $19.40 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $20.80 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $22.10 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $22.90 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $23.70 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $25.90 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $32.00 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $33.70 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T4 | No | No | $33.70 | - |
Showing top 50 of 94 plans.
Medicare Advantage Plans (MA-PD) Covering risperidone 37.5 MG Injection [Risperdal]
6 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
Frequently Asked Questions
Is risperidone 37.5 MG Injection [Risperdal] covered by Medicare Part D?
Yes, risperidone 37.5 MG Injection [Risperdal] is covered by 1,341 Medicare Part D plans (26.5% of all Part D formularies).
What tier is risperidone 37.5 MG Injection [Risperdal] on Medicare Part D plans?
risperidone 37.5 MG Injection [Risperdal] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.
Does risperidone 37.5 MG Injection [Risperdal] require prior authorization?
4.2% of Part D formularies require prior authorization for risperidone 37.5 MG Injection [Risperdal]. Step therapy: 8.3%. Quantity limits: 83.3%.
How much does Medicare spend on risperidone 37.5 MG Injection [Risperdal]?
In 2023, total Medicare Part D spending on risperidone 37.5 MG Injection [Risperdal] was $60,762,995, covering 478,904 beneficiaries. The average spend per beneficiary was $126.88.
Read our methodology - how this data is sourced, computed, and verified.