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Qulipta is a brand of atogepant. What agents check before quoting it: how many 2026 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2026, 4,016 of 5,496 Medicare Part D and Medicare Advantage drug plans (73.1%) list Qulipta on their formulary, across 207 of 328 formularies. The most common placement is tier 3 (1,898 plans, 47.3% of those covering it). 3,896 of the covering plans require prior authorization (97%), 0 step therapy and 3,875 a quantity limit.
342 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $45, 64 of them $0; 3,674 charge coinsurance instead — median 25% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,100 in 2026, covered drugs cost $0 for the rest of the year.
2025: 3,899 of 5,631 plans covered it (69.2%); 2026: 4,016 of 5,496 (73.1%).
Of 4,368 plans offered in both years, 101 added it to the formulary and 52 dropped it.
Among plans covering it both years, 29 moved it to a higher tier and 9 to a lower one; 0 added prior authorization and 16 removed it.
Medicare Part D paid for 243,834 30-day fills of Qulipta in 2024 for about 45,031 enrollees, at an average total cost of $1,047 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
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Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 09/16/2026). CMS formulary data.