SOFOSBUVIR AND VELPATASVIR 100/400 mg Tablet, Film Coated
Also known as Velpatasvir And Sofosbuvir. Coverage in New Jersey (CMS PDP Region 04).
4 of 12 stand-alone Part D plans in New Jersey cover this drug on tier 5.
4 of 4 plans apply a prior authorization, step therapy or quantity limit.
21 Medicare Advantage plans in NJ 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. NJ: 21 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $256.5611 | $7,696.8330 units |
|
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $256.5611 | $7,696.8330 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $288.8804 | $8,666.4130 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $288.8804 | $8,666.4130 units |
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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.