vamorolone 40 MG/ML Oral Suspension [Agamree]

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vamorolone

RxCUI: 2669810

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
0.4%
Plan Coverage
21
Plans Covering
T3.5
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for vamorolone 40 MG/ML Oral Suspension [Agamree]

Per the CMS 2026 Part D formulary file, vamorolone 40 MG/ML Oral Suspension [Agamree] (RxNorm concept RXCUI 2669810, generic name vamorolone) appears on 8 distinct formulary files spanning 21 Medicare Part D plan offerings - 0.4% 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 3.5.

Real-world access to vamorolone 40 MG/ML Oral Suspension [Agamree] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 37.5% 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 vamorolone 40 MG/ML Oral Suspension [Agamree] today.

Coverage Details

Formularies covering
8
Plans covering
21
Coverage rate
0.4%
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
37.5% of formularies

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
18 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering vamorolone 40 MG/ML Oral Suspension [Agamree]

21 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 Yes $0 MA
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T5 Yes $0 MA
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Mass General Brigham Advantage (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $0 MA
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T5 Yes $0 OR
Health First Value H1099-006 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $15.00 FL
Health First Classic H1099-001 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $49.40 FL
Fallon Medicare Plus Green (HMO) FALLON COMMUNITY HEALTH PLAN T5 Yes $56.40 MA
Mass General Brigham Advantage Secure (HMO-POS) Mass General Brigham Health Plan, Inc. T5 Yes $62.00 MA
Fallon Medicare Plus Blue (HMO) FALLON COMMUNITY HEALTH PLAN T5 Yes $72.10 MA
Mass General Brigham Advantage Premier (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $79.70 MA
Mass General Brigham Advantage Signature (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $147.20 MA

Frequently Asked Questions

Is vamorolone 40 MG/ML Oral Suspension [Agamree] covered by Medicare Part D?

Yes, vamorolone 40 MG/ML Oral Suspension [Agamree] is covered by 21 Medicare Part D plans (0.4% of all Part D formularies).

What tier is vamorolone 40 MG/ML Oral Suspension [Agamree] on Medicare Part D plans?

vamorolone 40 MG/ML Oral Suspension [Agamree] averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 5.

Does vamorolone 40 MG/ML Oral Suspension [Agamree] require prior authorization?

100% of Part D formularies require prior authorization for vamorolone 40 MG/ML Oral Suspension [Agamree]. Step therapy: 0%. Quantity limits: 37.5%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial