Hycamtin

Generic: topotecan

25MG, 1MG — Capsule

Also known as: Hycamtin Oral HYCAMTIN CAPS .25MG, 1MG topotecan Hycamtin 0.25 Mg Capsule Hycamtin 1 Mg Capsule

Coverage by Insurer

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

Ambetter (Centene)

58 plans

Source: CMS QHP JSON · Formulary date: Jan 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Standard Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Focused Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver with Atrium Health + Vision + Adult Dental	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold via topotecan	Tier 5 - Specialty	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options via topotecan	Tier 5 - Specialty	—	—	✓	QL
Everyday Bronze via topotecan	Tier 5 - Specialty	—	—	✓	QL
Elite Bronze via topotecan	Tier 5 - Specialty	—	—	✓	QL
Clear Silver with $0 Insulin Options via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Expanded Bronze via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Silver via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Gold via topotecan	Tier 5 - Specialty	—	—	✓	QL
Everyday Bronze with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Elite Bronze with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Focused Silver with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Complete Gold with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Expanded Bronze with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Silver with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Gold with Atrium Health via topotecan	Tier 5 - Specialty	—	—	✓	QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Complete Gold + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Everyday Bronze + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Elite Bronze + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Everyday Bronze with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Elite Bronze with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Focused Silver with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Complete Gold with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Expanded Bronze + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Silver + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Gold + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Silver with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Standard Gold with Atrium Health + Vision + Adult Dental via topotecan	Tier 5 - Specialty	—	—	✓	QL
Complete Gold with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Complete Gold	Tier 5 - Specialty	✓	—	✓	PA \| QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Clear Silver with $0 Insulin Options	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Expanded Bronze	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Silver	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold	Tier 5 - Specialty	✓	—	✓	PA \| QL
Everyday Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Elite Bronze with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Focused Silver with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL
Standard Gold with Atrium Health	Tier 5 - Specialty	✓	—	✓	PA \| QL

Blue Cross Blue Shield Federal

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Focus 2026	Tier 2 - Preferred Brand	—	—	—	None
BCBS Federal Standard Option 2026	Tier 4 - Preferred Specialty	—	—	—	None
BCBS Federal Basic Option 2026	Tier 4 - Preferred Specialty	—	—	—	None

Blue Cross Blue Shield of NC

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026	Tier 5 - Specialty	✓	—	—	PA
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	✓	—	—	PA
BCBSNC Blue Local 2026	Tier 5 - Specialty	✓	—	—	PA
BCBSNC Blue Care 2026	Tier 5 - Specialty	✓	—	—	PA
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	✓	—	—	PA

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 4 - Specialty	✓	—	— Specialty Pharmacy Required	PA

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 6 - Non-Preferred Brand Specialty	✓	—	—	PA
NC State Health Plan - 70/30 Standard PPO 2026	Tier 6 - Non-Preferred Brand Specialty	✓	—	—	PA
NC State Health Plan - HDHP 2026	Tier 6 - Non-Preferred Brand Specialty	✓	—	—	PA

UnitedHealthcare

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 9 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Unknown	✓	—	✓	PA \| QL