tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]

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tiopronin

RxCUI: 2702682

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.
3.2%
Plan Coverage
161
Plans Covering
T4
Avg Tier
25%
Prior Auth Required

What the CMS Formulary Data Shows for tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]

Per the CMS 2026 Part D formulary file, tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] (RxNorm concept RXCUI 2702682, generic name tiopronin) appears on 12 distinct formulary files spanning 161 Medicare Part D plan offerings - 3.2% 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.

Real-world access to tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] depends on utilization management as much as tier placement: 25% 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 [Venxxiva] 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 [Venxxiva] today.

Coverage Details

Formularies covering
12
Plans covering
161
Coverage rate
3.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
25% 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

3 plans
Tier 1, Preferred Generic
97 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
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
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
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
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
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T5 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T5 No $0 CO

Frequently Asked Questions

Is tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] covered by Medicare Part D?

Yes, tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] is covered by 161 Medicare Part D plans (3.2% of all Part D formularies).

What tier is tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] on Medicare Part D plans?

tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.

Does tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] require prior authorization?

25% of Part D formularies require prior authorization for tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]?

In 2023, total Medicare Part D spending on tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] 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