Medicare Part D coverage · tiopronin · RxCUI 2178075
tiopronin 100 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, tiopronin 100 MG Delayed Release Oral Tablet is covered by 222 Medicare Part D plans (4.4% of enrollable products), averaging Tier 4.2, with prior authorization required on 63.3% of covering formularies.
- 4.4%
- Plan coverage
- 222
- Plans covering
- T4.2
- Avg tier
- 63.3%
- Prior auth required
What the CMS Formulary Data Shows for tiopronin 100 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, tiopronin 100 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 2178075, generic name tiopronin) appears on 30 distinct formulary files spanning 222 Medicare Part D plan offerings - 4.4% 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 4.2.
Real-world access to tiopronin 100 MG Delayed Release Oral Tablet depends on utilization management as much as tier placement: 63.3% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 261 Part D beneficiaries filled tiopronin 100 MG Delayed Release Oral Tablet in 2023, with total plan-and-beneficiary spending of $23,230,085 and an average per-beneficiary annual cost of $89,004.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tiopronin 100 MG Delayed Release Oral Tablet today.
Coverage Details
- Formularies covering
- 30
- Plans covering
- 222
- Coverage rate
- 4.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 63.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 261
- Total spending
- $23,230,085
- Avg per beneficiary
- $89,004.16
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tiopronin 100 MG Delayed Release Oral Tablet
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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | No | $0 | NY |
| Network Health Select (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Go (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
Show the next 30 plans
| 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 |
| 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 |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Michigan, Inc. | T5 | Yes | $0 | MI |
| Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Enhanced Solano (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Inland Empire (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Ventura (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Enhanced Kern (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Basic Kern (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage San Diego (HMO) | Kaiser Foundation HP, Inc. | T5 | No | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is tiopronin 100 MG Delayed Release Oral Tablet covered by Medicare Part D?
Yes, tiopronin 100 MG Delayed Release Oral Tablet is covered by 222 Medicare Part D plans (4.4% of all Part D formularies).
What tier is tiopronin 100 MG Delayed Release Oral Tablet on Medicare Part D plans?
tiopronin 100 MG Delayed Release Oral Tablet averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does tiopronin 100 MG Delayed Release Oral Tablet require prior authorization?
63.3% of Part D formularies require prior authorization for tiopronin 100 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on tiopronin 100 MG Delayed Release Oral Tablet?
In 2023, total Medicare Part D spending on tiopronin 100 MG Delayed Release Oral Tablet was $23,230,085, covering 261 beneficiaries. The average spend per beneficiary was $89,004.16.
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
- dasatinib 20 MG Oral Tablet T4.2
- rilpivirine 2.5 MG Tablet for Oral Suspension [Edurant] T4.2
- tenofovir disoproxil fumarate 250 MG Oral Tablet [Viread] T4.2
- sodium oxybate 500 MG/ML Oral Solution T4.2
- sapropterin dihydrochloride 100 MG Oral Tablet T4.2
- ivacaftor 125 MG / lumacaftor 200 MG Oral Tablet [ORKAMBI] T4.2
Similar prior-authorization rate
- teriflunomide 14 MG Oral Tablet 63.3% PA
- lactulose 20000 MG Powder for Oral Solution [Kristalose] 63.6% PA
- ivermectin 3 MG Oral Tablet 63.7% PA
- alosetron 0.5 MG Oral Tablet 62.8% PA
- alosetron 1 MG Oral Tablet 62.8% PA
- 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] 62.5% PA