Medicare Part D coverage · vibegron · RxCUI 2472321
vibegron 75 MG Oral Tablet [Gemtesa]
Per the CMS 2026 Part D formulary file, vibegron 75 MG Oral Tablet [Gemtesa] is covered by 4,072 Medicare Part D plans (80.6% of enrollable products), averaging Tier 3, with prior authorization required on 0.9% of covering formularies.
- 80.6%
- Plan coverage
- 4,072
- Plans covering
- T3
- Avg tier
- 0.9%
- Prior auth required
What the CMS Formulary Data Shows for vibegron 75 MG Oral Tablet [Gemtesa]
Per the CMS 2026 Part D formulary file, vibegron 75 MG Oral Tablet [Gemtesa] (RxNorm concept RXCUI 2472321, generic name vibegron) appears on 217 distinct formulary files spanning 4,072 Medicare Part D plan offerings - 80.6% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to vibegron 75 MG Oral Tablet [Gemtesa] depends on utilization management as much as tier placement: 0.9% of covering formularies require prior authorization. 0.5% require step therapy. 70.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 187,161 Part D beneficiaries filled vibegron 75 MG Oral Tablet [Gemtesa] in 2023, with total plan-and-beneficiary spending of $508,474,527 and an average per-beneficiary annual cost of $2,716.78. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry vibegron 75 MG Oral Tablet [Gemtesa] today.
Coverage Details
- Formularies covering
- 217
- Plans covering
- 4,072
- Coverage rate
- 80.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0.9% of formularies
- Step therapy required
- 0.5% of formularies
- Quantity limits
- 70.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 187,161
- Total spending
- $508,474,527
- Avg per beneficiary
- $2,716.78
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering vibegron 75 MG Oral Tablet [Gemtesa]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
Show the next 30 plans
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is vibegron 75 MG Oral Tablet [Gemtesa] covered by Medicare Part D?
Yes, vibegron 75 MG Oral Tablet [Gemtesa] is covered by 4,072 Medicare Part D plans (80.6% of all Part D formularies).
What tier is vibegron 75 MG Oral Tablet [Gemtesa] on Medicare Part D plans?
vibegron 75 MG Oral Tablet [Gemtesa] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does vibegron 75 MG Oral Tablet [Gemtesa] require prior authorization?
0.9% of Part D formularies require prior authorization for vibegron 75 MG Oral Tablet [Gemtesa]. Step therapy: 0.5%. Quantity limits: 70.5%.
How much does Medicare spend on vibegron 75 MG Oral Tablet [Gemtesa]?
In 2023, total Medicare Part D spending on vibegron 75 MG Oral Tablet [Gemtesa] was $508,474,527, covering 187,161 beneficiaries. The average spend per beneficiary was $2,716.78.
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
Similar prior-authorization rate
- tramadol hydrochloride 50 MG Oral Tablet 0.9% PA
- cycloserine 250 MG Oral Capsule 0.9% PA
- acetaminophen 300 MG / codeine phosphate 60 MG Oral Tablet 0.9% PA
- acetaminophen 300 MG / codeine phosphate 15 MG Oral Tablet 0.9% PA
- acetaminophen 24 MG/ML / codeine phosphate 2.4 MG/ML Oral Solution 0.9% PA
- oxycodone hydrochloride 5 MG Oral Tablet 0.9% PA