Medicare Part D coverage · zavegepant · RxCUI 2637980
zavegepant 10 MG Nasal Spray [Zavzpret]
Per the CMS 2026 Part D formulary file, zavegepant 10 MG Nasal Spray [Zavzpret] is covered by 261 Medicare Part D plans (5.2% of enrollable products), averaging Tier 3, with prior authorization required on 97.8% of covering formularies.
- 5.2%
- Plan coverage
- 261
- Plans covering
- T3
- Avg tier
- 97.8%
- Prior auth required
What the CMS Formulary Data Shows for zavegepant 10 MG Nasal Spray [Zavzpret]
Per the CMS 2026 Part D formulary file, zavegepant 10 MG Nasal Spray [Zavzpret] (RxNorm concept RXCUI 2637980, generic name zavegepant) appears on 46 distinct formulary files spanning 261 Medicare Part D plan offerings - 5.2% 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 3.
Real-world access to zavegepant 10 MG Nasal Spray [Zavzpret] depends on utilization management as much as tier placement: 97.8% of covering formularies require prior authorization. 0% require step therapy. 95.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 999 Part D beneficiaries filled zavegepant 10 MG Nasal Spray [Zavzpret] in 2023, with total plan-and-beneficiary spending of $2,306,719 and an average per-beneficiary annual cost of $2,309.03. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry zavegepant 10 MG Nasal Spray [Zavzpret] today.
Coverage Details
- Formularies covering
- 46
- Plans covering
- 261
- Coverage rate
- 5.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 97.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 95.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 999
- Total spending
- $2,306,719
- Avg per beneficiary
- $2,309.03
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering zavegepant 10 MG Nasal Spray [Zavzpret]
100 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 |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| 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 |
| 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 |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| 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 |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | Yes | $14.70 | NC |
| KeyCare Advantage (HMO I-SNP) | Isnp Ventures, LLC | T1 | Yes | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | Yes | $23.80 | MS |
| 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 |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | Yes | $25.40 | GA |
Show the next 30 plans
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | Yes | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | Yes | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | Simpra Advantage, Inc. | T1 | Yes | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | Yes | $28.20 | OK |
| 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 |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | Yes | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | Lagniappe Advantage Insurance Company | T1 | Yes | $32.90 | LA |
| American Health Advantage of Louisiana (HMO I-SNP) | Dignity Care Corporation | 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 |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Liberty Advantage, LLC | T1 | Yes | $36.20 | NC |
| American Health Advantage of Utah (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | Yes | $37.60 | UT |
| American Health Advantage of Idaho (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | Yes | $37.60 | ID |
| American Health Advantage of Indiana (HMO I-SNP) | American Health Plan OF Indiana Inc | T1 | Yes | $38.40 | IN |
| Iowa Health Advantage (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | Yes | $41.50 | IA |
| Iowa Health Advantage Choice (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | Yes | $41.50 | IA |
| American Health Advantage of Missouri (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| American Health Advantage of Missouri Choice (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | Yes | $43.00 | MO |
| Kansas Health Advantage (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | Yes | $55.20 | KS |
| Kansas Health Advantage Choice (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | Yes | $55.20 | KS |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| KeyCare Advantage Plus (HMO C-SNP) | Isnp Ventures, LLC | T3 | Yes | $0 | MD |
| Premier Care (HMO-POS I-SNP) | Lifeworks Advantage, LLC | T3 | Yes | $0 | VA |
| Premier Care (HMO I-SNP) | Align Senior Care California Inc. | T3 | Yes | $0 | CA |
| Advantage Care (HMO) | Align Senior Care California Inc. | T3 | Yes | $0 | CA |
| Premier Care (HMO-POS I-SNP) | Align Senior Care MI, LLC | T3 | Yes | $0 | MI |
| Premier Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T3 | Yes | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is zavegepant 10 MG Nasal Spray [Zavzpret] covered by Medicare Part D?
Yes, zavegepant 10 MG Nasal Spray [Zavzpret] is covered by 261 Medicare Part D plans (5.2% of all Part D formularies).
What tier is zavegepant 10 MG Nasal Spray [Zavzpret] on Medicare Part D plans?
zavegepant 10 MG Nasal Spray [Zavzpret] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.
Does zavegepant 10 MG Nasal Spray [Zavzpret] require prior authorization?
97.8% of Part D formularies require prior authorization for zavegepant 10 MG Nasal Spray [Zavzpret]. Step therapy: 0%. Quantity limits: 95.7%.
How much does Medicare spend on zavegepant 10 MG Nasal Spray [Zavzpret]?
In 2023, total Medicare Part D spending on zavegepant 10 MG Nasal Spray [Zavzpret] was $2,306,719, covering 999 beneficiaries. The average spend per beneficiary was $2,309.03.
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
- alpha 1-proteinase inhibitor, human 1 MG Injection [Aralast] 97.8% PA
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix 4.25/5] 97.8% PA
- alanine 10.4 MG/ML / arginine 5.75 MG/ML / glucose 200 MG/ML / glycine 5.15 MG/ML / histidine 2.4 MG/ML / isoleucine 3 MG/ML / leucine 3.65 MG/ML / lysine 2.9 MG/ML / methionine 2 MG/ML / phenylalanine 2.8 MG/ML / proline 3.4 MG/ML / serine 2.5 MG/ML / threonine 2.1 MG/ML / tryptophan 0.9 MG/ML / tyrosine 0.2 MG/ML / valine 2.9 MG/ML Injectable Solution [Clinimix 5/20] 97.8% PA
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / glucose 100 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix 4.25/10] 97.8% PA
- {4 (ozanimod 0.23 MG Oral Capsule [Zeposia]) / 3 (ozanimod 0.46 MG Oral Capsule [Zeposia]) / 21 (ozanimod 0.92 MG Oral Capsule [Zeposia]) } Pack [Zeposia 28-Day Starter Kit] 97.7% PA
- levalbuterol 0.417 MG/ML Inhalation Solution 97.7% PA