Medicare Part D coverage · topiramate · RxCUI 2586433
topiramate 25 MG/ML Oral Solution [Eprontia]
Per the CMS 2026 Part D formulary file, topiramate 25 MG/ML Oral Solution [Eprontia] is covered by 3,092 Medicare Part D plans (61.2% of enrollable products), averaging Tier 3.7, with prior authorization required on 41.4% of covering formularies.
- 61.2%
- Plan coverage
- 3,092
- Plans covering
- T3.7
- Avg tier
- 41.4%
- Prior auth required
What the CMS Formulary Data Shows for topiramate 25 MG/ML Oral Solution [Eprontia]
Per the CMS 2026 Part D formulary file, topiramate 25 MG/ML Oral Solution [Eprontia] (RxNorm concept RXCUI 2586433, generic name topiramate) appears on 70 distinct formulary files spanning 3,092 Medicare Part D plan offerings - 61.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.7.
Real-world access to topiramate 25 MG/ML Oral Solution [Eprontia] depends on utilization management as much as tier placement: 41.4% of covering formularies require prior authorization. 8.6% require step therapy. 32.9% 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/ML Oral Solution [Eprontia] in 2023, with total plan-and-beneficiary spending of $56,440,596 and an average per-beneficiary annual cost of $87.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry topiramate 25 MG/ML Oral Solution [Eprontia] today.
Coverage Details
- Formularies covering
- 70
- Plans covering
- 3,092
- Coverage rate
- 61.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 41.4% of formularies
- Step therapy required
- 8.6% of formularies
- Quantity limits
- 32.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 644,196
- Total spending
- $56,440,596
- Avg per beneficiary
- $87.61
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering topiramate 25 MG/ML Oral Solution [Eprontia]
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 | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering topiramate 25 MG/ML Oral Solution [Eprontia]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | No | $38.40 | KY |
Show the next 30 plans
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T3 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | Yes | $0 | FL |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is topiramate 25 MG/ML Oral Solution [Eprontia] covered by Medicare Part D?
Yes, topiramate 25 MG/ML Oral Solution [Eprontia] is covered by 3,092 Medicare Part D plans (61.2% of all Part D formularies).
What tier is topiramate 25 MG/ML Oral Solution [Eprontia] on Medicare Part D plans?
topiramate 25 MG/ML Oral Solution [Eprontia] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does topiramate 25 MG/ML Oral Solution [Eprontia] require prior authorization?
41.4% of Part D formularies require prior authorization for topiramate 25 MG/ML Oral Solution [Eprontia]. Step therapy: 8.6%. Quantity limits: 32.9%.
How much does Medicare spend on topiramate 25 MG/ML Oral Solution [Eprontia]?
In 2023, total Medicare Part D spending on topiramate 25 MG/ML Oral Solution [Eprontia] was $56,440,596, covering 644,196 beneficiaries. The average spend per beneficiary was $87.61.
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
- 24 HR topiramate 200 MG Extended Release Oral Capsule T3.7
- {6 (1 ML certolizumab pegol 200 MG/ML Prefilled Syringe [Cimzia]) } Pack [Cimzia Starter Kit (6 count)] T3.7
- fingolimod 0.5 MG Oral Capsule T3.8
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.16 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 14 MG/ML / lysine 8.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.4 MG/ML / valine 7.8 MG/ML Injectable Solution [PremaSol] T3.8
- risperidone 12.5 MG Injection [Risperdal] T3.8
- ledipasvir 90 MG / sofosbuvir 400 MG Oral Tablet T3.8
Similar prior-authorization rate
- isotretinoin 20 MG Oral Capsule 41.4% PA
- isotretinoin 30 MG Oral Capsule 41.4% PA
- methylprednisolone 32 MG Oral Tablet 41.5% PA
- methylprednisolone 16 MG Oral Tablet 41.5% PA
- methylprednisolone 8 MG Oral Tablet 41.5% PA
- dicyclomine hydrochloride 10 MG Oral Capsule 41.5% PA