elbasvir/grazoprevir

50 mg-100 mg — Tablet

HEPATITIS C AGENTS

Also known as: ZEPATIER

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 1 hour, 41 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary PA
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