tiopronin 300 MG Delayed Release Oral Tablet

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tiopronin

RxCUI: 2178079

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.
4.4%
Plan Coverage
222
Plans Covering
T4.2
Avg Tier
63.3%
Prior Auth Required

What the CMS Formulary Data Shows for tiopronin 300 MG Delayed Release Oral Tablet

Per the CMS 2026 Part D formulary file, tiopronin 300 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 2178079, 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 300 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 300 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 300 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

10 plans
Tier 1, Preferred Generic
90 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering tiopronin 300 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
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

Frequently Asked Questions

Is tiopronin 300 MG Delayed Release Oral Tablet covered by Medicare Part D?

Yes, tiopronin 300 MG Delayed Release Oral Tablet is covered by 222 Medicare Part D plans (4.4% of all Part D formularies).

What tier is tiopronin 300 MG Delayed Release Oral Tablet on Medicare Part D plans?

tiopronin 300 MG Delayed Release Oral Tablet averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does tiopronin 300 MG Delayed Release Oral Tablet require prior authorization?

63.3% of Part D formularies require prior authorization for tiopronin 300 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on tiopronin 300 MG Delayed Release Oral Tablet?

In 2023, total Medicare Part D spending on tiopronin 300 MG Delayed Release Oral Tablet was $23,230,085, covering 261 beneficiaries. The average spend per beneficiary was $89,004.16.

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