PROLIA 60 mg/mL Injection
Also known as Denosumab. Coverage in Arkansas (CMS PDP Region 19).
7 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 4.
7 of 7 plans apply a prior authorization, step therapy or quantity limit.
41 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: 41 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 | 4Non-Preferred Drug | 29% | 29% | $1842.3999 | $313.210.17 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $1863.8143 | $316.850.17 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $1863.8143 | $316.850.17 units |
|
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | 34% | $1876.1294 | $318.940.17 units |
|
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $1841.4529 | $313.050.17 units |
|
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1863.8143 | $316.850.17 units |
|
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 34% | 34% | $1876.1294 | $318.940.17 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.