See the DrugPatentWatch profile for repatha
What “tier” is Repatha on?
“Repatha” (evolocumab) is typically placed on a prescription drug formulary tier determined by a specific health plan’s coverage rules. The tier can vary widely by insurer, employer plan, Medicaid managed-care plan, and pharmacy benefit manager.
What tier usually means for patients (copay impact)
In most formularies, lower tiers usually mean lower out-of-pocket costs. Common patterns are:
- Lower tiers (often generic or preferred brand) cost less.
- Higher tiers (often non-preferred brand or specialty drugs) cost more, sometimes requiring prior authorization or step therapy.
Because Repatha is a specialty injectable in many plans, it is frequently on a higher tier than common oral medications—but the exact tier depends on the plan.
How to find the exact tier for your plan
Check your plan’s formulary or “drug list” for Repatha (evolocumab). If you have the drug’s NDC or the plan’s exact name, you can search the formulary more precisely. You can also ask your insurer or pharmacy benefit manager for:
- Repatha tier level
- any prior authorization requirements
- whether you need step therapy
- expected copay/coinsurance at that tier
If you tell me your plan, I can help narrow it
If you share the insurer and plan type (for example, “Aetna commercial,” “Anthem Blue Cross PPO,” “Medicare Part D plan name,” or your formulary link), I can help interpret what tier that plan typically uses for Repatha and what to look for in the formulary.