Kisunla
Generic: donanemab-azbt
350MG/20ML — Vial
Also known as:
donanemab-azbt
KISUNLA SOLN 350MG/20ML
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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.
Ambetter (Centene)
34 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Silver + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Gold + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Silver with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Gold with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Clear Silver with $0 Insulin Options | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Expanded Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Silver | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Gold | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Focused Silver with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Expanded Bronze with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Silver with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Gold with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Complete Gold | Tier 5 - Specialty | ✓ | — | — | PA |
| Enhanced Asthma/COPD Care Silver $0 Rx Options | Tier 5 - Specialty | ✓ | — | — | PA |
| Everyday Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Elite Bronze | Tier 5 - Specialty | ✓ | — | — | PA |
| Streamlined Silver with Atrium Health | Tier 5 - Specialty | ✓ | — | — | PA |
| Streamlined Silver | Tier 5 - Specialty | ✓ | — | — | PA |
| Clear Silver with $0 Insulin Options + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Signature Expanded Bronze + Vision + Adult Dental | Tier 5 - Specialty | ✓ | — | — | PA |
| Enhanced CHF Heart Care Silver $0 Rx Options | Tier 5 - Specialty | ✓ | — | — | PA |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Medical Benefit | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Medical Benefit | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Medical Benefit | — | — | — | None |