Litfulo

Generic: ritlecitinib

50 MG — Capsule

DERMATOLOGICALS

Also known as: ritlecitinib LITFULO CAPS 50MG

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 12 hours, 36 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 5 - Specialty Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 5 - Specialty Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Local 2026 Tier 5 - Specialty Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Care 2026 Tier 5 - Specialty Restricted Access; Limited Distribution PA | QL
BCBSNC Blue Value 2026 Tier 5 - Specialty Restricted Access; Limited Distribution PA | QL
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 12 hours, 36 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic 28 per 28 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic 28 per 28 days PA | QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic 28 per 28 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic 28 per 28 days PA | QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 5 - Specialty PA
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 5 - Specialty 30 per 30 days PA | QL
Senior Care (HMO I-SNP) Tier 5 - Specialty 28 per 28 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty 28 per 28 days PA | QL
Troy Medicare (HMO) Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 12 hours, 36 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 70/30 Standard PPO 2026 Tier 5 - Preferred Brand Specialty PA
NC State Health Plan - HDHP 2026 Tier 5 - Preferred Brand Specialty PA
NC State Health Plan - 80/20 Plus PPO 2026 Tier 5 - Preferred Brand Specialty PA
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