Medicare Part D coverage · sodium phenylbutyrate · RxCUI 2610134
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] is covered by 86 Medicare Part D plans (1.7% of enrollable products), averaging Tier 5.1, with prior authorization required on 100% of covering formularies.
- 1.7%
- Plan coverage
- 86
- Plans covering
- T5.1
- Avg tier
- 100%
- Prior auth required
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 84 plans.
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.
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
- 0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector T5
- metronidazole 10 MG/ML Topical Cream [Noritate] T5
- 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe T5
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] T5
- deferiprone 1000 MG Oral Tablet [Ferriprox] T5
- ruxolitinib 15 MG/ML Topical Cream [Opzelura] T5
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA