Medicare Part D coverage · sofosbuvir · RxCUI 2203893
sofosbuvir 200 MG Oral Tablet [Sovaldi]
Per the CMS 2026 Part D formulary file, sofosbuvir 200 MG Oral Tablet [Sovaldi] is covered by 191 Medicare Part D plans (3.8% of enrollable products), averaging Tier 4.4, with prior authorization required on 80% of covering formularies.
- 3.8%
- Plan coverage
- 191
- Plans covering
- T4.4
- Avg tier
- 80%
- Prior auth required
What the CMS Formulary Data Shows for sofosbuvir 200 MG Oral Tablet [Sovaldi]
Per the CMS 2026 Part D formulary file, sofosbuvir 200 MG Oral Tablet [Sovaldi] (RxNorm concept RXCUI 2203893, generic name sofosbuvir) appears on 5 distinct formulary files spanning 191 Medicare Part D plan offerings - 3.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 5, with a cross-plan average of Tier 4.4.
Real-world access to sofosbuvir 200 MG Oral Tablet [Sovaldi] depends on utilization management as much as tier placement: 80% of covering formularies require prior authorization. 0% require step therapy. 60% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 18 Part D beneficiaries filled sofosbuvir 200 MG Oral Tablet [Sovaldi] in 2023, with total plan-and-beneficiary spending of $1,955,322 and an average per-beneficiary annual cost of $108,629.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sofosbuvir 200 MG Oral Tablet [Sovaldi] today.
Coverage Details
- Formularies covering
- 5
- Plans covering
- 191
- Coverage rate
- 3.8%
- Tier range
- Tier 2 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 80% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 60% of formularies
2023 Medicare Spending
- Beneficiaries
- 18
- Total spending
- $1,955,322
- Avg per beneficiary
- $108,629.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sofosbuvir 200 MG Oral Tablet [Sovaldi]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Network Health Select (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Go (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Choice (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Zero (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Alignment Health the ONE + Walgreens (HMO) | Alignment Health Plan OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | Alignment Health Plan OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Alignment Health smartHMO (HMO) | Alignment Health Plan OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Alignment Health My Choice (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Platinum + Instacart (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health AllCare Preferred (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Platinum + Instacart (HMO-POS) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health My Choice (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Harmony (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Balance (HMO C-SNP) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health the ONE (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
Show the next 30 plans
| Alignment Health the ONE + Walgreens (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health CommUnity (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health smartSavings (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health My Choice Select (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health ValorCare (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health L.A. Premium Giveback (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health S.D. Premium Giveback (HMO) | Alignment Health Plan | T5 | Yes | $0 | CA |
| Alignment Health Platinum (HMO) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NC |
| Alignment Health NC Duals (HMO-POS D-SNP) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NC |
| Alignment Health smartHMO (HMO) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NC |
| Alignment Health Platinum + Instacart (HMO) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NV |
| Alignment Health smartHMO (HMO) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NV |
| Alignment Health Platinum Select (HMO) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NC |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan OF North Carolina, Inc. | T5 | Yes | $0 | NC |
| Alignment Health the ONE + Walgreens (HMO-POS) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health Heart & Diabetes (HMO-POS C-SNP) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health smartHMO (HMO-POS) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health Dual Select+ (HMO-POS D-SNP) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health Total Dual+ (HMO-POS D-SNP) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health smartSavings (HMO-POS) | Alignment Health Insurance Company OF Arizona Inc | T5 | Yes | $0 | TX |
| Alignment Health Advantage PPO (PPO) | Alignment Health Advantage Plan Inc | T5 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan OF Nevada, Inc. | T5 | Yes | $0 | NV |
| Alignment Health the ONE (HMO D-SNP) | Alignment Health Plan OF Nevada, Inc. | T5 | Yes | $0 | NV |
| Alignment Health Platinum + Instacart (HMO) | Alignment Health Plan OF Nevada, Inc. | T5 | Yes | $0 | NV |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sofosbuvir 200 MG Oral Tablet [Sovaldi] covered by Medicare Part D?
Yes, sofosbuvir 200 MG Oral Tablet [Sovaldi] is covered by 191 Medicare Part D plans (3.8% of all Part D formularies).
What tier is sofosbuvir 200 MG Oral Tablet [Sovaldi] on Medicare Part D plans?
sofosbuvir 200 MG Oral Tablet [Sovaldi] averages Tier 4.4 across Part D plans, ranging from Tier 2 to Tier 5.
Does sofosbuvir 200 MG Oral Tablet [Sovaldi] require prior authorization?
80% of Part D formularies require prior authorization for sofosbuvir 200 MG Oral Tablet [Sovaldi]. Step therapy: 0%. Quantity limits: 60%.
How much does Medicare spend on sofosbuvir 200 MG Oral Tablet [Sovaldi]?
In 2023, total Medicare Part D spending on sofosbuvir 200 MG Oral Tablet [Sovaldi] was $1,955,322, covering 18 beneficiaries. The average spend per beneficiary was $108,629.02.
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
- cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] T4.4
- ceftaroline fosamil 600 MG Injection [Teflaro] T4.4
- sapropterin dihydrochloride 500 MG Powder for Oral Solution [Zelvysia] T4.4
- eliglustat 84 MG Oral Capsule [Cerdelga] T4.4
- {28 (alpelisib 50 MG Oral Granules [Vijoice]) } Pack [Vijoice 50 MG Granules 28 Day] T4.4
- sinecatechins 0.15 MG/MG Topical Ointment [Veregen] T4.4
Similar prior-authorization rate
- 1 ML meperidine hydrochloride 50 MG/ML Injection 80% PA
- 24 HR hydromorphone hydrochloride 32 MG Extended Release Oral Tablet 80% PA
- 72 HR fentanyl 0.0625 MG/HR Transdermal System 80% PA
- 24 HR diazoxide choline 150 MG Extended Release Oral Tablet [Vykat] 80% PA
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] 80% PA
- 1 ML evolocumab 140 MG/ML Prefilled Syringe [Repatha] 80.1% PA