sertraline 200 MG Oral Capsule
sertraline
RxCUI: 251201
What the CMS Formulary Data Shows for sertraline 200 MG Oral Capsule
Per the CMS 2026 Part D formulary file, sertraline 200 MG Oral Capsule (RxNorm concept RXCUI 251201, generic name sertraline) appears on 9 distinct formulary files spanning 170 Medicare Part D plan offerings - 3.4% 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 3.1.
Real-world access to sertraline 200 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 11.1% require step therapy. 22.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,041,276 Part D beneficiaries filled sertraline 200 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $173,568,167 and an average per-beneficiary annual cost of $57.07. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sertraline 200 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 170
- Coverage rate
- 3.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 11.1% of formularies
- Quantity limits
- 22.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,041,276
- Total spending
- $173,568,167
- Avg per beneficiary
- $57.07
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sertraline 200 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is sertraline 200 MG Oral Capsule covered by Medicare Part D?
Yes, sertraline 200 MG Oral Capsule is covered by 170 Medicare Part D plans (3.4% of all Part D formularies).
What tier is sertraline 200 MG Oral Capsule on Medicare Part D plans?
sertraline 200 MG Oral Capsule averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does sertraline 200 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for sertraline 200 MG Oral Capsule. Step therapy: 11.1%. Quantity limits: 22.2%.
How much does Medicare spend on sertraline 200 MG Oral Capsule?
In 2023, total Medicare Part D spending on sertraline 200 MG Oral Capsule was $173,568,167, covering 3,041,276 beneficiaries. The average spend per beneficiary was $57.07.
Read our methodology - how this data is sourced, computed, and verified.