Medicare Part D coverage · treprostinil · RxCUI 2697739
treprostinil 0.08 MG Inhalation Powder [Tyvaso]
Per the CMS 2026 Part D formulary file, treprostinil 0.08 MG Inhalation Powder [Tyvaso] is covered by 59 Medicare Part D plans (1.2% of enrollable products), averaging Tier 4.4, with prior authorization required on 100% of covering formularies.
- 1.2%
- Plan coverage
- 59
- Plans covering
- T4.4
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for treprostinil 0.08 MG Inhalation Powder [Tyvaso]
Per the CMS 2026 Part D formulary file, treprostinil 0.08 MG Inhalation Powder [Tyvaso] (RxNorm concept RXCUI 2697739, generic name treprostinil) appears on 17 distinct formulary files spanning 59 Medicare Part D plan offerings - 1.2% 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 4.4.
Real-world access to treprostinil 0.08 MG Inhalation Powder [Tyvaso] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 23.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,017 Part D beneficiaries filled treprostinil 0.08 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 0.08 MG Inhalation Powder [Tyvaso] today.
Coverage Details
- Formularies covering
- 17
- Plans covering
- 59
- Coverage rate
- 1.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 23.5% 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 0.08 MG Inhalation Powder [Tyvaso]
59 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 |
Show the next 30 plans
| 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 |
| Geisinger Gold Value Rx (HMO) | Geisinger Health Plan | T5 | Yes | $23.00 | PA |
| Keystone 65 Essential Rx (HMO-POS) | Keystone Health Plan East, Inc. | T5 | Yes | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | Amerihealth Insurance Company OF NEW Jersey | T5 | Yes | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T5 | Yes | $47.00 | PA |
| Geisinger Gold Classic Complete Rx (HMO) | Geisinger Health Plan | T5 | Yes | $48.00 | PA |
Showing top 50 of 59 plans.
Frequently Asked Questions
Is treprostinil 0.08 MG Inhalation Powder [Tyvaso] covered by Medicare Part D?
Yes, treprostinil 0.08 MG Inhalation Powder [Tyvaso] is covered by 59 Medicare Part D plans (1.2% of all Part D formularies).
What tier is treprostinil 0.08 MG Inhalation Powder [Tyvaso] on Medicare Part D plans?
treprostinil 0.08 MG Inhalation Powder [Tyvaso] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does treprostinil 0.08 MG Inhalation Powder [Tyvaso] require prior authorization?
100% of Part D formularies require prior authorization for treprostinil 0.08 MG Inhalation Powder [Tyvaso]. Step therapy: 0%. Quantity limits: 23.5%.
How much does Medicare spend on treprostinil 0.08 MG Inhalation Powder [Tyvaso]?
In 2023, total Medicare Part D spending on treprostinil 0.08 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.
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
- nitisinone 20 MG Oral Capsule T4.4
- {6 (0.2 ML interferon beta-1a 0.044 MG/ML Prefilled Syringe [Rebif]) / 6 (0.5 ML interferon beta-1a 0.044 MG/ML Prefilled Syringe [Rebif]) } Pack [Rebif Titration] T4.4
- 1.5 ML brodalumab 140 MG/ML Prefilled Syringe [Siliq] T4.4
- {112 (treprostinil 0.032 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.064 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 32-64 MCG Maintenance Pack] T4.4
- nitisinone 2 MG Oral Capsule T4.3
- Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
Similar prior-authorization rate
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- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
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