ARISTADA 662 mg/2.4mL Injection, Suspension, Extended Release
Also known as Aripiprazole Lauroxil. Coverage in Alaska (CMS PDP Region 34).
8 of 9 stand-alone Part D plans in Alaska cover this drug on tier 4–5.
6 of 8 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | — | $994.4393 | $2,983.323 units |
|
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $994.4393 | $2,983.323 units |
|
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $994.4393 | $2,983.323 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1206.3519 | $3,619.063 units |
|
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1206.3519 | $3,619.063 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1032.9112 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1037.9595 | $3,113.883 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $1032.9112 | — | 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.