Medicare drug coverage

Brilinta: 2027 Medicare Part D coverage

35 of 5,495 Part D plans (1%) list Brilinta on their 2027 formulary, down 2 points from 2026. 0% of those require prior authorization, step therapy, or a quantity limit.

License. US government work, Public Domain Mark 1.0.

2027 compared with 2026

Brilinta is number 70 by total Medicare Part D spending in 2024 ($685 million). Plans that list it most often put it on tier 3. Counts use 3 RxNorm products for this name.

Brilinta Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it171 (3%)35 (1%)-2 points
Prior authorization (of plans that list it)0 (0%)0 (0%)no change
Step therapy (of plans that list it)0 (0%)0 (0%)no change
Quantity limit (of plans that list it)0 (0%)0 (0%)no change
Any of the three (of plans that list it)0 (0%)0 (0%)no change
Not listed or restricted (of all plans)5,347 (97%)5,460 (99%)+2 points

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

Formulary tier

Brilinta formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 17 (4%)0 (0%)
Tier 24 (2%)0 (0%)
Tier 3100 (58%)35 (100%)
Tier 460 (35%)0 (0%)

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

Plan by plan, 2026 to 2027

4,380 plan ids are in both files. 0 of them (0%) added prior authorization, step therapy, or a quantity limit for Brilinta, and 123 stopped listing it.

Brilinta: plans in both 2026 and 2027
Plan by planPlans
Same plan id in both years4,380
Listed it in 2026, not in 2027123 (3%)
Listed it in 2027, not in 20260 (0%)
Moved it to a higher tier0 (0%)
Added prior authorization0 (0%)
Added step therapy0 (0%)
Added a quantity limit0 (0%)
Added at least one of the three0 (0%)
Removed at least one of the three0 (0%)
Plan ids new in 20271,115
2026 plan ids not in the 2027 file1,138

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page

States from most to least restrictive

Share of 2027 Part D plans offered in each state that leave Brilinta off the formulary or list it with prior authorization, step therapy, or a quantity limit. Alaska ranks first at 100%, with 0% of its plans using prior authorization or step therapy; Nevada ranks last at 90%. Ties break on the prior authorization or step therapy share.

States from most to least restrictive for Brilinta, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1Alaska9100%0%no change
2Alabama115100%0%no change
3Arkansas86100%0%no change
4Arizona148100%0%no change
5California397100%0%+1 point
6Colorado106100%0%no change
7Connecticut54100%0%no change
8District of Columbia21100%0%no change
9Delaware43100%0%+5 points
10Georgia151100%0%+2 points
11Hawaii50100%0%no change
12Iowa64100%0%+6 points
13Idaho45100%0%no change
14Illinois133100%0%no change
15Indiana140100%0%no change
16Kansas84100%0%no change
17Kentucky123100%0%no change
18Louisiana126100%0%+1 point
19Maryland49100%0%no change
20Maine52100%0%no change
21Michigan183100%0%+24 points
22Minnesota63100%0%+7 points
23Missouri171100%0%no change
24Mississippi105100%0%no change
25Montana27100%0%no change
26North Carolina177100%0%+2 points
27North Dakota26100%0%+6 points
28Nebraska51100%0%no change
29New Hampshire25100%0%no change
30New Jersey74100%0%+8 points
31New Mexico68100%0%no change
32New York215100%0%+1 point
33Ohio173100%0%no change
34Oklahoma81100%0%no change
35Oregon92100%0%no change
36Pennsylvania324100%0%+7 points
37Rhode Island29100%0%no change
38South Carolina91100%0%+1 point
39South Dakota30100%0%no change
40Tennessee157100%0%+14 points
41Utah53100%0%no change
42Virginia145100%0%+1 point
43Vermont14100%0%no change
44Washington114100%0%no change
45Wisconsin97100%0%+10 points
46West Virginia70100%0%no change
47Wyoming13100%0%+11 points
48Florida54999%0%+2 points
49Texas41297%0%no change
50Massachusetts9293%0%-2 points
51Nevada10090%0%-3 points

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

By parent organization

164 parent organizations offer 2027 Part D plans. Humana Inc. has the most, 884, and 100% of them leave Brilinta off or restrict it.

Brilinta coverage by parent organization, 2027
Parent organization2027 plans ↓List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
Humana Inc.8840%none list it100%no change0
UnitedHealth Group, Inc.8500%none list it100%no change0
Devoted Health, Inc.7280%none list it100%no change0
CVS Health Corporation6330%none list it100%no change0
Elevance Health, Inc.2940%none list it100%no change0
Centene Corporation2680%none list it100%no change0
Health Care Service Corporation2310%none list it100%no change0
Kaiser Foundation Health Plan, Inc.1120%none list it100%no change0
Highmark Health980%none list it100%no change0
SCAN Group850%none list it100%no change0
Alignment Healthcare USA, LLC770%none list it100%no change0
Guidewell Mutual Holding Corporation550%none list it100%no change0
Blue Cross Blue Shield of Michigan Mutual Ins. Co.430%none list it100%+94 points0
Molina Healthcare, Inc.430%none list it100%no change0
Corewell Health400%none list it100%no change0
Zing Health Consolidator, Inc360%none list it100%no change0
CAPITAL BLUE CROSS350%none list it100%no change0
Medica Holding Company310%none list it100%no change0
UPMC Health System300%none list it100%no change0
Universal Health Services, Inc.29100%0%0%no change0
MHH Healthcare, L.P.260%none list it100%no change0
Independence Health Group, Inc.250%none list it100%+100 points0
Point32Health, Inc.230%none list it100%no change0
BlueCross BlueShield of Tennessee220%none list it100%+100 points0
California Physicians' Service220%none list it100%no change0

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Run it in Rivvi

Which 2027 plans near you dropped or restricted Brilinta?

Tier changes and new prior auth, step therapy or quantity limits, plan by plan, before open enrollment.

Free to start. Opens Rivvi, the AI workspace for healthcare teams.

Near it by Part D spending

About this data

A plan here is one Part D plan as the CMS formulary files list it: contract, plan, and segment. That covers Medicare Advantage plans with drug coverage and stand-alone drug plans. A plan lists a drug when its formulary has a row for any RxNorm product of that name. When it has several, the row with the lowest tier is the one counted, and restricted means that row has prior authorization, step therapy, or a quantity limit.

A plan with no row for the drug counts as not listing it. That can be a product the file codes another way, so read a low count as a lookup result, not a coverage decision. A state counts every plan the CMS landscape file offers there. Parent organizations are named as CMS names them. The drug list is the top 200 by total Part D spending.

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page

Source: CMS Medicare Part D Spending by Drug, 2024 data, as of June 25, 2026. Publisher page

Try it on your own data today.

Free to start. Most teams are using it the same day.

Get started for freeSee pricing