cladribine

Generic: Mavenclad

10 mg, 10 mg, 10 mg, 10 mg, 10 mg, 10 mg, 10 mg — Tablet

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS

Also known as: cladribine soln 10mg/10ml cladribine tab therapy pack 10 mg (4 tabs), 10 mg (5 tabs), 10 mg (6 tabs), 10 mg (7 tabs), 10 mg (8 tabs), 10 mg (9 tabs), 10 mg (10 tabs)

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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 14 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Mavenclad	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026 via Mavenclad	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Local 2026 via Mavenclad	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Care 2026 via Mavenclad	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL
BCBSNC Blue Value 2026 via Mavenclad	Tier 5 - Specialty	✓	—	✓ Restricted Access; Limited Distribution	PA \| QL

Medicare Part D

3 plans

Source: CMS QHP JSON · Formulary date: Mar 18, 2026 · Checked: 5 hours, 14 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
AmeriHealth Caritas VIP Care (HMO D-SNP) via Mavenclad	Tier 5 - Specialty	✓	—	—	PA
Troy Medicare (HMO) via Mavenclad	Tier 5 - Specialty	✓	—	—	PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) via Mavenclad	Tier 5 - Specialty	✓	—	—	PA

NC Medicaid PDL

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 14 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Mavenclad	Non-Preferred	—	—	—	None

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 14 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 1 - Preferred Generic	—	—	—	None