tiotropium 0.018 MG Inhalation Powder [Spiriva]

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tiotropium

RxCUI: 580261

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.
42%
Plan Coverage
2,130
Plans Covering
T2.8
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for tiotropium 0.018 MG Inhalation Powder [Spiriva]

Per the CMS 2026 Part D formulary file, tiotropium 0.018 MG Inhalation Powder [Spiriva] (RxNorm concept RXCUI 580261, generic name tiotropium) appears on 46 distinct formulary files spanning 2,130 Medicare Part D plan offerings - 42% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.8.

Real-world access to tiotropium 0.018 MG Inhalation Powder [Spiriva] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 2.2% require step therapy. 93.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 333,929 Part D beneficiaries filled tiotropium 0.018 MG Inhalation Powder [Spiriva] in 2023, with total plan-and-beneficiary spending of $923,556,171 and an average per-beneficiary annual cost of $2,765.73. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tiotropium 0.018 MG Inhalation Powder [Spiriva] today.

Coverage Details

Formularies covering
46
Plans covering
2,130
Coverage rate
42%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
2.2% of formularies
Quantity limits
93.5% of formularies

2023 Medicare Spending

Beneficiaries
333,929
Total spending
$923,556,171
Avg per beneficiary
$2,765.73

Tier Distribution Across Plans

13 plans
Tier 1, Preferred Generic
42 plans
Tier 2, Generic
45 plans
Tier 3, Preferred Brand

Standalone Drug Plans (PDP) Covering tiotropium 0.018 MG Inhalation Powder [Spiriva]

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -

Medicare Advantage Plans (MA-PD) Covering tiotropium 0.018 MG Inhalation Powder [Spiriva]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 No $0 PR
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $31.20 DE
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL

Frequently Asked Questions

Is tiotropium 0.018 MG Inhalation Powder [Spiriva] covered by Medicare Part D?

Yes, tiotropium 0.018 MG Inhalation Powder [Spiriva] is covered by 2,130 Medicare Part D plans (42% of all Part D formularies).

What tier is tiotropium 0.018 MG Inhalation Powder [Spiriva] on Medicare Part D plans?

tiotropium 0.018 MG Inhalation Powder [Spiriva] averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does tiotropium 0.018 MG Inhalation Powder [Spiriva] require prior authorization?

0% of Part D formularies require prior authorization for tiotropium 0.018 MG Inhalation Powder [Spiriva]. Step therapy: 2.2%. Quantity limits: 93.5%.

How much does Medicare spend on tiotropium 0.018 MG Inhalation Powder [Spiriva]?

In 2023, total Medicare Part D spending on tiotropium 0.018 MG Inhalation Powder [Spiriva] was $923,556,171, covering 333,929 beneficiaries. The average spend per beneficiary was $2,765.73.

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