Medicare Part D coverage · tiopronin · RxCUI 2702682
tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva]
Per the CMS 2026 Part D formulary file, tiopronin 100 MG Delayed Release Oral Tablet [Venxxiva] is covered by 161 Medicare Part D plans (3.2% of enrollable products), averaging Tier 4, with prior authorization required on 25% of covering formularies.
- 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
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 |
Show the next 30 plans
Showing top 50 of 100 plans.
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.
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
- dihydroergotamine mesylate 0.5 MG/ACTUAT Metered Dose Nasal Spray T4
- 0.5 ML darbepoetin alfa 0.2 MG/ML Prefilled Syringe [Aranesp] T4
- amoxicillin 250 MG / omeprazole 10 MG / rifabutin 12.5 MG Delayed Release Oral Capsule [Talicia] T4
- timolol hemihydrate 5 MG/ML Ophthalmic Solution [Betimol] T4
- deflazacort 18 MG Oral Tablet [Jaythari] T4
- bepotastine besilate 15 MG/ML Ophthalmic Solution [Bepreve] T4
Similar prior-authorization rate
- lorazepam 0.5 MG Oral Tablet 25% PA
- insulin lispro-aabc 100 UNT/ML Injectable Solution [Lyumjev] 25% PA
- desipramine hydrochloride 10 MG Oral Tablet 25% PA
- desipramine hydrochloride 100 MG Oral Tablet 25% PA
- methotrexate 5 MG Oral Tablet [Trexall] 25% PA
- Modified 24 HR metformin hydrochloride 1000 MG Extended Release Oral Tablet 25% PA