KESIMPTA 20 mg/.4mL Injection, Solution

Also known as Ofatumumab. Coverage in New Mexico (CMS PDP Region 26).

3 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 5.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

57 Medicare Advantage plans in NM 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. NM: 57 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$23148.8987	$46,297.802 units	Prior authorization Quantity limit 1.6 per 28 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$25337.6321	$50,675.262 units	Prior authorization Quantity limit 1.6 per 28 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$25428.4854	$50,856.972 units	Prior authorization Quantity limit 1.6 per 28 days

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.

See coverage in all 39 regions →