Medicare Part D coverage · rufinamide · RxCUI 1092360
rufinamide 40 MG/ML Oral Suspension [Banzel]
Per the CMS 2026 Part D formulary file, rufinamide 40 MG/ML Oral Suspension [Banzel] is covered by 12 Medicare Part D plans (0.2% of enrollable products), averaging Tier 2.3, with prior authorization required on 0% of covering formularies.
- 0.2%
- Plan coverage
- 12
- Plans covering
- T2.3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for rufinamide 40 MG/ML Oral Suspension [Banzel]
Per the CMS 2026 Part D formulary file, rufinamide 40 MG/ML Oral Suspension [Banzel] (RxNorm concept RXCUI 1092360, generic name rufinamide) appears on 3 distinct formulary files spanning 12 Medicare Part D plan offerings - 0.2% 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 2.3.
Real-world access to rufinamide 40 MG/ML Oral Suspension [Banzel] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,232 Part D beneficiaries filled rufinamide 40 MG/ML Oral Suspension [Banzel] in 2023, with total plan-and-beneficiary spending of $39,245,407 and an average per-beneficiary annual cost of $17,583.07. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry rufinamide 40 MG/ML Oral Suspension [Banzel] today.
Coverage Details
- Formularies covering
- 3
- Plans covering
- 12
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,232
- Total spending
- $39,245,407
- Avg per beneficiary
- $17,583.07
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering rufinamide 40 MG/ML Oral Suspension [Banzel]
12 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 |
| Óptimo Plus (PPO) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
| Brillante (HMO-POS) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
| Enlace Plus (HMO) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
| Ahorro Plus (HMO) | Triple S Advantage, Inc. | T5 | No | $0 | PR |
Frequently Asked Questions
Is rufinamide 40 MG/ML Oral Suspension [Banzel] covered by Medicare Part D?
Yes, rufinamide 40 MG/ML Oral Suspension [Banzel] is covered by 12 Medicare Part D plans (0.2% of all Part D formularies).
What tier is rufinamide 40 MG/ML Oral Suspension [Banzel] on Medicare Part D plans?
rufinamide 40 MG/ML Oral Suspension [Banzel] averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does rufinamide 40 MG/ML Oral Suspension [Banzel] require prior authorization?
0% of Part D formularies require prior authorization for rufinamide 40 MG/ML Oral Suspension [Banzel]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on rufinamide 40 MG/ML Oral Suspension [Banzel]?
In 2023, total Medicare Part D spending on rufinamide 40 MG/ML Oral Suspension [Banzel] was $39,245,407, covering 2,232 beneficiaries. The average spend per beneficiary was $17,583.07.
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
- 0.25 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac] T2.3
- 0.5 ML acellular pertussis vaccine, inactivated 0.116 MG/ML / diphtheria toxoid vaccine, inactivated 50 UNT/ML / hepatitis B surface antigen vaccine 0.02 MG/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Prefilled Syringe [PEDIARIX] T2.3
- acetaminophen 325 MG / oxycodone hydrochloride 5 MG Oral Tablet T2.3
- sodium polystyrene sulfonate 15000 MG Powder for Oral Suspension T2.3
- oxycodone hydrochloride 30 MG Oral Tablet T2.3
- fosinopril sodium 10 MG Oral Tablet T2.3
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA