sofosbuvir 400 MG Oral Tablet [Sovaldi]
sofosbuvir
RxCUI: 1484922
What the CMS Formulary Data Shows for sofosbuvir 400 MG Oral Tablet [Sovaldi]
Per the CMS 2026 Part D formulary file, sofosbuvir 400 MG Oral Tablet [Sovaldi] (RxNorm concept RXCUI 1484922, generic name sofosbuvir) appears on 6 distinct formulary files spanning 192 Medicare Part D plan offerings - 3.8% 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 3.8.
Real-world access to sofosbuvir 400 MG Oral Tablet [Sovaldi] depends on utilization management as much as tier placement: 83.3% of covering formularies require prior authorization. 0% require step therapy. 50% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 18 Part D beneficiaries filled sofosbuvir 400 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 400 MG Oral Tablet [Sovaldi] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 192
- Coverage rate
- 3.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 83.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 50% 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 400 MG Oral Tablet [Sovaldi]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | Yes | $0 | WI |
| 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 |
| 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 |
Frequently Asked Questions
Is sofosbuvir 400 MG Oral Tablet [Sovaldi] covered by Medicare Part D?
Yes, sofosbuvir 400 MG Oral Tablet [Sovaldi] is covered by 192 Medicare Part D plans (3.8% of all Part D formularies).
What tier is sofosbuvir 400 MG Oral Tablet [Sovaldi] on Medicare Part D plans?
sofosbuvir 400 MG Oral Tablet [Sovaldi] averages Tier 3.8 across Part D plans, ranging from Tier 1 to Tier 5.
Does sofosbuvir 400 MG Oral Tablet [Sovaldi] require prior authorization?
83.3% of Part D formularies require prior authorization for sofosbuvir 400 MG Oral Tablet [Sovaldi]. Step therapy: 0%. Quantity limits: 50%.
How much does Medicare spend on sofosbuvir 400 MG Oral Tablet [Sovaldi]?
In 2023, total Medicare Part D spending on sofosbuvir 400 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.