topiramate 25 MG Oral Capsule
topiramate
RxCUI: 205315
What the CMS Formulary Data Shows for topiramate 25 MG Oral Capsule
Per the CMS 2026 Part D formulary file, topiramate 25 MG Oral Capsule (RxNorm concept RXCUI 205315, generic name topiramate) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.
Real-world access to topiramate 25 MG Oral Capsule depends on utilization management as much as tier placement: 7.9% 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 644,196 Part D beneficiaries filled topiramate 25 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $56,441,529 and an average per-beneficiary annual cost of $87.62. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry topiramate 25 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 7.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 644,196
- Total spending
- $56,441,529
- Avg per beneficiary
- $87.62
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering topiramate 25 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is topiramate 25 MG Oral Capsule covered by Medicare Part D?
Yes, topiramate 25 MG Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is topiramate 25 MG Oral Capsule on Medicare Part D plans?
topiramate 25 MG Oral Capsule averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does topiramate 25 MG Oral Capsule require prior authorization?
7.9% of Part D formularies require prior authorization for topiramate 25 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on topiramate 25 MG Oral Capsule?
In 2023, total Medicare Part D spending on topiramate 25 MG Oral Capsule was $56,441,529, covering 644,196 beneficiaries. The average spend per beneficiary was $87.62.
Read our methodology - how this data is sourced, computed, and verified.