treprostinil 0.064 MG Inhalation Powder [Tyvaso]
treprostinil
RxCUI: 2602766
What the CMS Formulary Data Shows for treprostinil 0.064 MG Inhalation Powder [Tyvaso]
Per the CMS 2026 Part D formulary file, treprostinil 0.064 MG Inhalation Powder [Tyvaso] (RxNorm concept RXCUI 2602766, generic name treprostinil) appears on 19 distinct formulary files spanning 174 Medicare Part D plan offerings - 3.4% 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 4.4.
Real-world access to treprostinil 0.064 MG Inhalation Powder [Tyvaso] depends on utilization management as much as tier placement: 89.5% of covering formularies require prior authorization. 0% require step therapy. 21.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,017 Part D beneficiaries filled treprostinil 0.064 MG Inhalation Powder [Tyvaso] in 2023, with total plan-and-beneficiary spending of $436,921,533 and an average per-beneficiary annual cost of $144,819.87. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry treprostinil 0.064 MG Inhalation Powder [Tyvaso] today.
Coverage Details
- Formularies covering
- 19
- Plans covering
- 174
- Coverage rate
- 3.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 89.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 21.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,017
- Total spending
- $436,921,533
- Avg per beneficiary
- $144,819.87
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering treprostinil 0.064 MG Inhalation Powder [Tyvaso]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T5 | Yes | $0 | PA |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T5 | Yes | $0 | MI |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T5 | Yes | $0 | PR |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | Yes | $0 | NM |
| 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 |
Frequently Asked Questions
Is treprostinil 0.064 MG Inhalation Powder [Tyvaso] covered by Medicare Part D?
Yes, treprostinil 0.064 MG Inhalation Powder [Tyvaso] is covered by 174 Medicare Part D plans (3.4% of all Part D formularies).
What tier is treprostinil 0.064 MG Inhalation Powder [Tyvaso] on Medicare Part D plans?
treprostinil 0.064 MG Inhalation Powder [Tyvaso] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does treprostinil 0.064 MG Inhalation Powder [Tyvaso] require prior authorization?
89.5% of Part D formularies require prior authorization for treprostinil 0.064 MG Inhalation Powder [Tyvaso]. Step therapy: 0%. Quantity limits: 21.1%.
How much does Medicare spend on treprostinil 0.064 MG Inhalation Powder [Tyvaso]?
In 2023, total Medicare Part D spending on treprostinil 0.064 MG Inhalation Powder [Tyvaso] was $436,921,533, covering 3,017 beneficiaries. The average spend per beneficiary was $144,819.87.
Read our methodology - how this data is sourced, computed, and verified.