TRULICITY .75 mg/.5mL Injection, Solution
Also known as Dulaglutide. Coverage in Arizona (CMS PDP Region 28).
7 of 10 stand-alone Part D plans in Arizona cover this drug on tier 3–6.
Lowest 30-day cost $11.00 at a preferred pharmacy. 7 of 7 plans apply a prior authorization, step therapy or quantity limit.
125 Medicare Advantage plans in AZ do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. AZ: 125 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $470.1328 | $940.272 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $486.1546 | $972.312 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $516.3117 | $1,032.622 units |
|
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $485.4552 | $970.912 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $516.3117 | $1,032.622 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $489.6163 | $979.232 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 6Select Care Drugs | $11.00 | $33.00 | $470.1328 | $940.272 units |
|
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.