triheptanoin 1000 MG/ML Oral Solution [Dojolvi]
triheptanoin
RxCUI: 2383561
What the CMS Formulary Data Shows for triheptanoin 1000 MG/ML Oral Solution [Dojolvi]
Per the CMS 2026 Part D formulary file, triheptanoin 1000 MG/ML Oral Solution [Dojolvi] (RxNorm concept RXCUI 2383561, generic name triheptanoin) appears on 24 distinct formulary files spanning 71 Medicare Part D plan offerings - 1.4% 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 3.4.
Real-world access to triheptanoin 1000 MG/ML Oral Solution [Dojolvi] depends on utilization management as much as tier placement: 83.3% 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 21 Part D beneficiaries filled triheptanoin 1000 MG/ML Oral Solution [Dojolvi] in 2023, with total plan-and-beneficiary spending of $2,635,754 and an average per-beneficiary annual cost of $125,512.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry triheptanoin 1000 MG/ML Oral Solution [Dojolvi] today.
Coverage Details
- Formularies covering
- 24
- Plans covering
- 71
- Coverage rate
- 1.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 83.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 21
- Total spending
- $2,635,754
- Avg per beneficiary
- $125,512.11
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering triheptanoin 1000 MG/ML Oral Solution [Dojolvi]
71 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $0 | GA |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | Yes | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | MARQUIS ADVANTAGE, INC. | T1 | Yes | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | Yes | $12.00 | CA |
| KeyCare Advantage (HMO I-SNP) | ISNP VENTURES, LLC | T1 | Yes | $23.20 | MD |
| Senior Care (HMO I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | Yes | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $25.40 | GA |
| NHC Advantage (HMO I-SNP) | NHC ADVANTAGE, LLC | T1 | Yes | $31.00 | MO, NC, SC, TN |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | Yes | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | LAGNIAPPE ADVANTAGE INSURANCE COMPANY | T1 | Yes | $32.90 | LA |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | Yes | $35.70 | SC |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | Yes | $36.20 | NC |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| KeyCare Advantage Plus (HMO C-SNP) | ISNP VENTURES, LLC | T5 | Yes | $0 | MD |
| Premier Care (HMO-POS I-SNP) | LIFEWORKS ADVANTAGE, LLC | T5 | Yes | $0 | VA |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Advantage Care (HMO) | ALIGN SENIOR CARE CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Premier Care (HMO-POS I-SNP) | ALIGN SENIOR CARE MI, LLC | T5 | Yes | $0 | MI |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T5 | Yes | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T5 | Yes | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T5 | Yes | $0 | CO |
| Perennial Advantage Freedom (HMO) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T5 | Yes | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T5 | Yes | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF OHIO, INC. | T5 | Yes | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T5 | Yes | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T5 | Yes | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T5 | Yes | $0 | GA |
| 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 |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T5 | No | $0 | MA |
| Senior Care (HMO I-SNP) | NHC ADVANTAGE, LLC | T5 | Yes | $0 | MO, NC, SC, TN |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T5 | Yes | $0 | OR |
Frequently Asked Questions
Is triheptanoin 1000 MG/ML Oral Solution [Dojolvi] covered by Medicare Part D?
Yes, triheptanoin 1000 MG/ML Oral Solution [Dojolvi] is covered by 71 Medicare Part D plans (1.4% of all Part D formularies).
What tier is triheptanoin 1000 MG/ML Oral Solution [Dojolvi] on Medicare Part D plans?
triheptanoin 1000 MG/ML Oral Solution [Dojolvi] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does triheptanoin 1000 MG/ML Oral Solution [Dojolvi] require prior authorization?
83.3% of Part D formularies require prior authorization for triheptanoin 1000 MG/ML Oral Solution [Dojolvi]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on triheptanoin 1000 MG/ML Oral Solution [Dojolvi]?
In 2023, total Medicare Part D spending on triheptanoin 1000 MG/ML Oral Solution [Dojolvi] was $2,635,754, covering 21 beneficiaries. The average spend per beneficiary was $125,512.11.
Read our methodology - how this data is sourced, computed, and verified.