saxagliptin 2.5 MG Oral Tablet

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saxagliptin

RxCUI: 858042

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.
10.7%
Plan Coverage
540
Plans Covering
T2.2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for saxagliptin 2.5 MG Oral Tablet

Per the CMS 2026 Part D formulary file, saxagliptin 2.5 MG Oral Tablet (RxNorm concept RXCUI 858042, generic name saxagliptin) appears on 47 distinct formulary files spanning 540 Medicare Part D plan offerings - 10.7% 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 2.2.

Real-world access to saxagliptin 2.5 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 2.1% require step therapy. 80.9% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 5,089 Part D beneficiaries filled saxagliptin 2.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $19,482,315 and an average per-beneficiary annual cost of $3,828.32. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry saxagliptin 2.5 MG Oral Tablet today.

Coverage Details

Formularies covering
47
Plans covering
540
Coverage rate
10.7%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
2.1% of formularies
Quantity limits
80.9% of formularies

2023 Medicare Spending

Beneficiaries
5,089
Total spending
$19,482,315
Avg per beneficiary
$3,828.32

Tier Distribution Across Plans

70 plans
Tier 1, Preferred Generic
30 plans
Tier 2, Generic

Standalone Drug Plans (PDP) Covering saxagliptin 2.5 MG Oral Tablet

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
CarePartners Access (PPO) CAREPARTNERS OF CONNECTICUT, INC. T1 No No $0 CT
CarePartners of CT CareAdvantage Preferred (HMO) CAREPARTNERS OF CONNECTICUT, INC. T1 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering saxagliptin 2.5 MG Oral Tablet

98 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T1 No $0 NV
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T1 No $0 MS
MMM Supremo (HMO C-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Unico (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Elite (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Deluxe (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
PMC Max (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Plenitud (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Valioso (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Grandioso (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Mega Flex (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Relax Platino (HMO D-SNP) MMM HEALTHCARE, LLC T1 No $0 PR
MMM Balance (HMO-POS) MMM HEALTHCARE, LLC T1 No $0 PR
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
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Tufts Medicare Preferred HMO Basic Rx (HMO) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Medicare Preferred HMO Smart Saver Rx (HMO) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Medicare Preferred PPO RX (PPO) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
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

Frequently Asked Questions

Is saxagliptin 2.5 MG Oral Tablet covered by Medicare Part D?

Yes, saxagliptin 2.5 MG Oral Tablet is covered by 540 Medicare Part D plans (10.7% of all Part D formularies).

What tier is saxagliptin 2.5 MG Oral Tablet on Medicare Part D plans?

saxagliptin 2.5 MG Oral Tablet averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does saxagliptin 2.5 MG Oral Tablet require prior authorization?

0% of Part D formularies require prior authorization for saxagliptin 2.5 MG Oral Tablet. Step therapy: 2.1%. Quantity limits: 80.9%.

How much does Medicare spend on saxagliptin 2.5 MG Oral Tablet?

In 2023, total Medicare Part D spending on saxagliptin 2.5 MG Oral Tablet was $19,482,315, covering 5,089 beneficiaries. The average spend per beneficiary was $3,828.32.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial