trientine hydrochloride 250 MG Oral Capsule [Syprine]
trientine hydrochloride
RxCUI: 208720
What the CMS Formulary Data Shows for trientine hydrochloride 250 MG Oral Capsule [Syprine]
Per the CMS 2026 Part D formulary file, trientine hydrochloride 250 MG Oral Capsule [Syprine] (RxNorm concept RXCUI 208720, generic name trientine hydrochloride) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.
Real-world access to trientine hydrochloride 250 MG Oral Capsule [Syprine] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry trientine hydrochloride 250 MG Oral Capsule [Syprine] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 2
- Coverage rate
- 0%
- Tier range
- Tier 1, Preferred Generic
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering trientine hydrochloride 250 MG Oral Capsule [Syprine]
2 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 | Yes | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
Frequently Asked Questions
Is trientine hydrochloride 250 MG Oral Capsule [Syprine] covered by Medicare Part D?
Yes, trientine hydrochloride 250 MG Oral Capsule [Syprine] is covered by 2 Medicare Part D plans (0% of all Part D formularies).
What tier is trientine hydrochloride 250 MG Oral Capsule [Syprine] on Medicare Part D plans?
trientine hydrochloride 250 MG Oral Capsule [Syprine] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.
Does trientine hydrochloride 250 MG Oral Capsule [Syprine] require prior authorization?
100% of Part D formularies require prior authorization for trientine hydrochloride 250 MG Oral Capsule [Syprine]. Step therapy: 0%. Quantity limits: 100%.
Read our methodology - how this data is sourced, computed, and verified.