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
Mavenclad
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)
Cladribine (10 Tabs) Oral Tablet Therapy Pack
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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.
AmeriHealth Caritas NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Mavenclad |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Medicare Part D
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Troy Medicare (HMO)
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Mavenclad |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
NC Medicaid PDL
2 plansNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Simple Diabetes | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| AIAN Cost Share | Tier 5 - Specialty | — | — | — | None |
| AIAN Cost Share | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic 4700 | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Secure | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Diabetes | Tier 5 - Specialty | — | — | — | None |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple PCP Saver | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic 4700 | Tier 5 - Specialty | — | — | — | None |
| Secure | Tier 5 - Specialty | — | — | — | None |
| Silver Classic | Tier 5 - Specialty | — | — | — | None |
| Bronze Elite + PCP Saver Plus | Tier 5 - Specialty | — | — | — | None |
| Gold Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic Standard | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Gold Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Silver Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Bronze Classic Standard | Tier 5 - Specialty | — | — | — | None |
| Gold Elite Saver Plus | Tier 5 - Specialty | — | — | — | None |
| Silver Classic | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple Diabetes | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Silver Simple PCP Saver | with Atrium Health | Tier 5 - Specialty | — | — | — | None |
| Gold Elite Saver Plus | with Atrium Health | Tier 5 - Specialty | — | — | — | None |