Medicare Part D coverage · sacubitril · RxCUI 1656346
sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]
Per the CMS 2026 Part D formulary file, sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] is covered by 337 Medicare Part D plans (6.7% of enrollable products), averaging Tier 2.6, with prior authorization required on 0% of covering formularies.
- 6.7%
- Plan coverage
- 337
- Plans covering
- T2.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]
Per the CMS 2026 Part D formulary file, sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] (RxNorm concept RXCUI 1656346, generic name sacubitril) appears on 74 distinct formulary files spanning 337 Medicare Part D plan offerings - 6.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.6.
Real-world access to sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 4.1% require step therapy. 97.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 663,587 Part D beneficiaries filled sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] in 2023, with total plan-and-beneficiary spending of $3,430,441,590 and an average per-beneficiary annual cost of $5,169.54. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] today.
Coverage Details
- Formularies covering
- 74
- Plans covering
- 337
- Coverage rate
- 6.7%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 4.1% of formularies
- Quantity limits
- 97.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 663,587
- Total spending
- $3,430,441,590
- Avg per beneficiary
- $5,169.54
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]
100 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 |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
Show the next 30 plans
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $58.80 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T2 | No | $0 | CA |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T2 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T2 | No | $0 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | No | $0 | CA |
| Leon MediExtra (HMO) | Leon Health, Inc. | T2 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T2 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T2 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T2 | No | $0 | FL |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T2 | No | $51.60 | NY |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| MCS Classicare RxMax (HMO) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS Advantage, Inc. | T3 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS Advantage, Inc. | T3 | No | $0 | PR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] covered by Medicare Part D?
Yes, sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] is covered by 337 Medicare Part D plans (6.7% of all Part D formularies).
What tier is sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] on Medicare Part D plans?
sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 6.
Does sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] require prior authorization?
0% of Part D formularies require prior authorization for sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]. Step therapy: 4.1%. Quantity limits: 97.3%.
How much does Medicare spend on sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto]?
In 2023, total Medicare Part D spending on sacubitril 24 MG / valsartan 26 MG Oral Tablet [Entresto] was $3,430,441,590, covering 663,587 beneficiaries. The average spend per beneficiary was $5,169.54.
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
Similar prior-authorization rate
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