sparsentan 200 MG Oral Tablet [Filspari]

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sparsentan

RxCUI: 2630546

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
2.8%
Plan Coverage
140
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 140 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
140
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

12 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
87 plans
Tier 5, Specialty

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
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

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 140 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.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial