MedicarePartD.guide

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ELTROMBOPAG 25 mg Powder, For Suspension

Also known as Eltrombopag Olamine. Coverage in Alaska (CMS PDP Region 34).

5 of 9 stand-alone Part D plans in Alaska cover this drug on tier 5.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$154.9520$2,789.1418 units
  • Prior authorization
  • Quantity limit 18 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$145.7971$2,624.3518 units
  • Prior authorization
  • Quantity limit 18 per 30 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible5Specialty Tier25%—$154.9520$2,789.1418 units
  • Prior authorization
  • Quantity limit 18 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible5Specialty Tier25%—$190.4031$3,427.2618 units
  • Prior authorization
  • Quantity limit 18 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible5Specialty Tier31%—$190.4031$3,427.2618 units
  • Prior authorization
  • Quantity limit 18 per 30 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.

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