siponimod 2 MG Oral Tablet [Mayzent]
siponimod
RxCUI: 2121100
What the CMS Formulary Data Shows for siponimod 2 MG Oral Tablet [Mayzent]
Per the CMS 2026 Part D formulary file, siponimod 2 MG Oral Tablet [Mayzent] (RxNorm concept RXCUI 2121100, generic name siponimod) appears on 121 distinct formulary files spanning 422 Medicare Part D plan offerings - 8.3% 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.
Real-world access to siponimod 2 MG Oral Tablet [Mayzent] depends on utilization management as much as tier placement: 73.6% of covering formularies require prior authorization. 0% require step therapy. 92.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 928 Part D beneficiaries filled siponimod 2 MG Oral Tablet [Mayzent] in 2023, with total plan-and-beneficiary spending of $79,550,294 and an average per-beneficiary annual cost of $85,722.30. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry siponimod 2 MG Oral Tablet [Mayzent] today.
Coverage Details
- Formularies covering
- 121
- Plans covering
- 422
- Coverage rate
- 8.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 73.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 92.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 928
- Total spending
- $79,550,294
- Avg per beneficiary
- $85,722.30
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering siponimod 2 MG Oral Tablet [Mayzent]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | Yes | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | AMERICAN HEALTH PLAN OF FL, INC. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | No | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | MARQUIS ADVANTAGE, INC. | T1 | No | $10.50 | OR, WA |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $12.00 | CA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Liberty Medicare Dual Plan (HMO D-SNP) | LIBERTY ADVANTAGE, LLC | T1 | No | $14.70 | NC |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | Yes | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| KeyCare Advantage (HMO I-SNP) | ISNP VENTURES, LLC | T1 | No | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | AMERICAN HEALTH PLAN OF MS, INC. | T1 | No | $23.80 | MS |
| Senior Care (HMO I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | No | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | AMERICAN HEALTH PLAN, INC. | T1 | No | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | OKLAHOMA SUPERIOR SELECT, INC. | T1 | No | $28.20 | OK |
Frequently Asked Questions
Is siponimod 2 MG Oral Tablet [Mayzent] covered by Medicare Part D?
Yes, siponimod 2 MG Oral Tablet [Mayzent] is covered by 422 Medicare Part D plans (8.3% of all Part D formularies).
What tier is siponimod 2 MG Oral Tablet [Mayzent] on Medicare Part D plans?
siponimod 2 MG Oral Tablet [Mayzent] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does siponimod 2 MG Oral Tablet [Mayzent] require prior authorization?
73.6% of Part D formularies require prior authorization for siponimod 2 MG Oral Tablet [Mayzent]. Step therapy: 0%. Quantity limits: 92.6%.
How much does Medicare spend on siponimod 2 MG Oral Tablet [Mayzent]?
In 2023, total Medicare Part D spending on siponimod 2 MG Oral Tablet [Mayzent] was $79,550,294, covering 928 beneficiaries. The average spend per beneficiary was $85,722.30.
Read our methodology - how this data is sourced, computed, and verified.