ZARXIO 480 ug/.8mL Injection, Solution
Also known as Filgrastim-Sndz. Coverage in Missouri (CMS PDP Region 18).
3 of 10 stand-alone Part D plans in Missouri cover this drug on tier 5.
1 of 3 plans apply a prior authorization, step therapy or quantity limit.
121 Medicare Advantage plans in MO 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. MO: 121 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $557.5033 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $539.9495 | — |
|
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $557.5033 | — | None |
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.