Medicare Part D coverage · sotagliflozin · RxCUI 2638693
sotagliflozin 400 MG Oral Tablet [Inpefa]
Per the CMS 2026 Part D formulary file, sotagliflozin 400 MG Oral Tablet [Inpefa] is covered by 76 Medicare Part D plans (1.5% of enrollable products), averaging Tier 2.2, with prior authorization required on 100% of covering formularies.
- 1.5%
- Plan coverage
- 76
- Plans covering
- T2.2
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for sotagliflozin 400 MG Oral Tablet [Inpefa]
Per the CMS 2026 Part D formulary file, sotagliflozin 400 MG Oral Tablet [Inpefa] (RxNorm concept RXCUI 2638693, generic name sotagliflozin) appears on 18 distinct formulary files spanning 76 Medicare Part D plan offerings - 1.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.2.
Real-world access to sotagliflozin 400 MG Oral Tablet [Inpefa] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 405 Part D beneficiaries filled sotagliflozin 400 MG Oral Tablet [Inpefa] in 2023, with total plan-and-beneficiary spending of $659,182 and an average per-beneficiary annual cost of $1,627.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sotagliflozin 400 MG Oral Tablet [Inpefa] today.
Coverage Details
- Formularies covering
- 18
- Plans covering
- 76
- Coverage rate
- 1.5%
- Tier range
- Tier 1 – Tier 3
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 405
- Total spending
- $659,182
- Avg per beneficiary
- $1,627.61
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sotagliflozin 400 MG Oral Tablet [Inpefa]
76 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | Yes | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF North Carolina, Inc. | T1 | Yes | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | Elderserve Health, Inc. | T1 | Yes | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF NEW York, Inc. | T1 | Yes | $58.80 | NY |
| The Health Plan SecureCare - Option II (HMO) | THE Health Plan OF West Virginia, Inc. | T3 | Yes | $0 | OH |
| The Health Plan SecureCare - Option II (HMO) | THE Health Plan OF West Virginia, Inc. | T3 | Yes | $0 | OH, WV |
| The Health Plan SecureCare Capitol Plan (HMO) | THE Health Plan OF West Virginia, Inc. | T3 | Yes | $0 | WV |
| The Health Plan SecureChoice Optimum (PPO) | THP Insurance Company | T3 | Yes | $0 | OH, WV |
| WellSense Signature (HMO) | Boston Medical Center Health Plan, Inc. | T3 | Yes | $0 | NH |
Show the next 30 plans
| WellSense Signature Access (PPO) | Boston Medical Center Health Plan, Inc. | T3 | Yes | $0 | NH |
| Essence Advantage (HMO) | Essence Healthcare, Inc. | T3 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | Essence Healthcare, Inc. | T3 | Yes | $0 | AR, MO |
| Essence Advantage Select (HMO) | Essence Healthcare, Inc. | T3 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | Essence Healthcare, Inc. | T3 | Yes | $0 | IN, KY |
| Essence Advantage Select (HMO) | Essence Healthcare, Inc. | T3 | Yes | $0 | IL |
| Essence Advantage Choice (PPO) | Essence Healthcare PPO, Inc. | T3 | Yes | $0 | IL, MO |
| Essence Advantage Choice (PPO) | Essence Healthcare PPO, Inc. | T3 | Yes | $0 | AR, MO |
| Essence Advantage Choice (PPO) | Essence Healthcare PPO, Inc. | T3 | Yes | $0 | IL |
| CareSource Dual Advantage Plus (HMO D-SNP) | Caresource Georgia Co. | T3 | Yes | $0 | GA |
| CareSource MyCare Ohio (HMO D-SNP) | Caresource Ohio, Inc. | T3 | Yes | $0 | OH |
| Blue adVantage Liberty (PPO) | Louisiana Health Service & Indemnity Company | T3 | Yes | $0 | LA |
| Blue adVantage Thrive (PPO) | Louisiana Health Service & Indemnity Company | T3 | Yes | $0 | LA |
| Blue adVantage Classic (HMO-POS) | HMO Louisiana, Inc. | T3 | Yes | $0 | LA |
| Blue adVantage Giveback (HMO-POS) | HMO Louisiana, Inc. | T3 | Yes | $0 | LA |
| Medica Advantage Solution H6154-001 (HMO-POS) | Medica Health Plans | T3 | Yes | $0 | MN |
| Medica Advantage Solution H8889-005 (PPO) | Medica Health Plans | T3 | Yes | $0 | MN |
| Medica Advantage Value (PPO) | Medica Health Plans | T3 | Yes | $0 | IA, NE |
| Medica Advantage Select (PPO) | Medica Health Plans | T3 | Yes | $0 | ND |
| Medica Advantage Value (PPO) | Medica Health Plans | T3 | Yes | $0 | ND |
| Medica Advantage Select (PPO) | Medica Health Plans | T3 | Yes | $0 | IA, NE |
| Medica Advantage Dual (PPO D-SNP) | Medica Health Plans | T3 | Yes | $0 | ND |
| Medica Advantage Value (PPO) | Medica Health Plans | T3 | Yes | $0 | SD |
| Medica Advantage Select (PPO) | Medica Health Plans | T3 | Yes | $0 | SD |
| Medica DUAL Solution (HMO D-SNP) | Medica Health Plans | T3 | Yes | $0 | MN |
| Cooperative Medicare Advantage (HMO) | Group Health Cooperative OF EAU Claire | T3 | Yes | $0 | WI |
| Banner Medicare Advantage Dual (HMO D-SNP) | Banner - University Care Advantage | T3 | Yes | $0 | AZ |
| Banner Medicare Advantage Dual (HMO D-SNP) | Banner - University Care Advantage | T3 | Yes | $0 | AZ |
| Banner Medicare Advantage Prime (HMO) | Banner Health Plan, Inc. | T3 | Yes | $0 | AZ |
| The Health Plan SecureChoice Reliance (PPO) | THP Insurance Company | T3 | Yes | $0.70 | WV |
Showing top 50 of 76 plans.
Frequently Asked Questions
Is sotagliflozin 400 MG Oral Tablet [Inpefa] covered by Medicare Part D?
Yes, sotagliflozin 400 MG Oral Tablet [Inpefa] is covered by 76 Medicare Part D plans (1.5% of all Part D formularies).
What tier is sotagliflozin 400 MG Oral Tablet [Inpefa] on Medicare Part D plans?
sotagliflozin 400 MG Oral Tablet [Inpefa] averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 3.
Does sotagliflozin 400 MG Oral Tablet [Inpefa] require prior authorization?
100% of Part D formularies require prior authorization for sotagliflozin 400 MG Oral Tablet [Inpefa]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on sotagliflozin 400 MG Oral Tablet [Inpefa]?
In 2023, total Medicare Part D spending on sotagliflozin 400 MG Oral Tablet [Inpefa] was $659,182, covering 405 beneficiaries. The average spend per beneficiary was $1,627.61.
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
- 0.5 ML Haemophilus influenzae type b strain 20752, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0.07 MG/ML Injection [Hiberix] T2.2
- promethazine hydrochloride 12.5 MG Oral Tablet T2.2
- misoprostol 0.1 MG Oral Tablet T2.2
- promethazine hydrochloride 25 MG Oral Tablet T2.2
- promethazine hydrochloride 50 MG Oral Tablet T2.2
- amphetamine aspartate 3.125 MG / amphetamine sulfate 3.125 MG / dextroamphetamine saccharate 3.125 MG / dextroamphetamine sulfate 3.125 MG Oral Tablet T2.2
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA