Medicare Part D coverage · sparsentan · RxCUI 2630546
sparsentan 200 MG Oral Tablet [Filspari]
Per the CMS 2026 Part D formulary file, sparsentan 200 MG Oral Tablet [Filspari] is covered by 139 Medicare Part D plans (2.8% of enrollable products), averaging Tier 4.3, with prior authorization required on 100% of covering formularies.
- 2.8%
- Plan coverage
- 139
- Plans covering
- T4.3
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for sparsentan 200 MG Oral Tablet [Filspari]
Per the CMS 2026 Part D formulary file, sparsentan 200 MG Oral Tablet [Filspari] (RxNorm concept RXCUI 2630546, generic name sparsentan) appears on 32 distinct formulary files spanning 139 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.3.
Real-world access to sparsentan 200 MG Oral Tablet [Filspari] depends on utilization management as much as tier placement: 100% 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 112 Part D beneficiaries filled sparsentan 200 MG Oral Tablet [Filspari] in 2023, with total plan-and-beneficiary spending of $4,777,836 and an average per-beneficiary annual cost of $42,659.25. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sparsentan 200 MG Oral Tablet [Filspari] today.
Coverage Details
- Formularies covering
- 32
- Plans covering
- 139
- Coverage rate
- 2.8%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 50% of formularies
2023 Medicare Spending
- Beneficiaries
- 112
- Total spending
- $4,777,836
- Avg per beneficiary
- $42,659.25
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sparsentan 200 MG Oral Tablet [Filspari]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $31.20 | DE |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
Show the next 30 plans
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Geisinger Gold Preferred Complete Rx (PPO) | Geisinger Indemnity Insurance Company | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Regence MedAdvantage + Rx Primary (PPO) | Regence Bluecross Blueshield OF Oregon | T5 | Yes | $0 | OR, WA |
| Regence BlueAdvantage HMO (HMO) | Regence Bluecross Blueshield OF Oregon | T5 | Yes | $0 | OR |
| 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 |
| Troy Medicare (HMO) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sparsentan 200 MG Oral Tablet [Filspari] covered by Medicare Part D?
Yes, sparsentan 200 MG Oral Tablet [Filspari] is covered by 139 Medicare Part D plans (2.8% of all Part D formularies).
What tier is sparsentan 200 MG Oral Tablet [Filspari] on Medicare Part D plans?
sparsentan 200 MG Oral Tablet [Filspari] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does sparsentan 200 MG Oral Tablet [Filspari] require prior authorization?
100% of Part D formularies require prior authorization for sparsentan 200 MG Oral Tablet [Filspari]. Step therapy: 0%. Quantity limits: 50%.
How much does Medicare spend on sparsentan 200 MG Oral Tablet [Filspari]?
In 2023, total Medicare Part D spending on sparsentan 200 MG Oral Tablet [Filspari] was $4,777,836, covering 112 beneficiaries. The average spend per beneficiary was $42,659.25.
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
Similar prior-authorization rate
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