sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]
sodium phenylbutyrate
RxCUI: 2610134
What the CMS Formulary Data Shows for sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]
Per the CMS 2026 Part D formulary file, sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] (RxNorm concept RXCUI 2610134, generic name sodium phenylbutyrate) appears on 8 distinct formulary files spanning 86 Medicare Part D plan offerings - 1.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 6, with a cross-plan average of Tier 5.1.
Real-world access to sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 62.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 69 Part D beneficiaries filled sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] in 2023, with total plan-and-beneficiary spending of $3,435,632 and an average per-beneficiary annual cost of $49,791.77. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] today.
Coverage Details
- Formularies covering
- 8
- Plans covering
- 86
- Coverage rate
- 1.7%
- Tier range
- Tier 5 – Tier 6
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 62.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 69
- Total spending
- $3,435,632
- Avg per beneficiary
- $49,791.77
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T5 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T5 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]
84 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Complete Blue HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK BCBSD INC. | T5 | Yes | $0 | DE |
| UPMC for Life HMO Premier Rx (HMO) | UPMC HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC HEALTH COVERAGE, INC. | T5 | Yes | $0 | PA |
| Senior Blue 652 (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0.40 | NY |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $1.00 | PA |
| UPMC for Life HMO Rx Choice (HMO) | UPMC HEALTH PLAN, INC. | T5 | Yes | $3.90 | OH, PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $6.00 | PA |
| Community Blue Medicare HMO Distinct (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $6.80 | NY |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T5 | Yes | $10.00 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $11.00 | PA |
| Complete Blue Plus PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $11.00 | PA |
| UPMC for Life HMO Deductible Rx (HMO) | UPMC HEALTH PLAN, INC. | T5 | Yes | $18.10 | OH, PA |
| UPMC for Life PPO Rx Choice (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $25.00 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $29.00 | WV |
| Senior Blue 651 (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $30.00 | NY |
| UPMC for Life PPO High Deductible Rx (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $33.00 | PA |
| UPMC for Life HMO Rx (HMO) | UPMC HEALTH PLAN, INC. | T5 | Yes | $33.70 | OH, PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK BCBSD INC. | T5 | Yes | $36.90 | DE |
| Freedom Blue PPO ValueRx (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $37.20 | PA |
| UPMC for Life PPO Rx Enhanced (PPO) | UPMC HEALTH NETWORK, INC. | T5 | Yes | $42.70 | PA |
| Freedom Blue PPO ValueRx (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $44.00 | PA |
| Independent Health's Assure Advantage (HMO C-SNP) | INDEPENDENT HEALTH ASSOCIATION, INC. | T5 | Yes | $46.50 | NY |
Frequently Asked Questions
Is sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] covered by Medicare Part D?
Yes, sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] is covered by 86 Medicare Part D plans (1.7% of all Part D formularies).
What tier is sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] on Medicare Part D plans?
sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] averages Tier 5.1 across Part D plans, ranging from Tier 5 to Tier 6.
Does sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] require prior authorization?
100% of Part D formularies require prior authorization for sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]. Step therapy: 0%. Quantity limits: 62.5%.
How much does Medicare spend on sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane]?
In 2023, total Medicare Part D spending on sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] was $3,435,632, covering 69 beneficiaries. The average spend per beneficiary was $49,791.77.
Read our methodology - how this data is sourced, computed, and verified.