QULIPTA 10 mg Tablet
Also known as Atogepant. Coverage in Arkansas (CMS PDP Region 19).
7 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 3–4.
7 of 7 plans apply a prior authorization, step therapy or quantity limit.
59 Medicare Advantage plans in AR 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. AR: 59 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $38.9798 | $116.943 units |
|
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $40.4735 | $121.423 units |
|
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 3Preferred Brand | 20% | 20% | $38.9798 | $116.943 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $38.2582 | $114.773 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $38.2582 | $114.773 units |
|
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $38.2582 | $114.773 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 29% | — | $41.0811 | $123.243 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.