mitapivat sulfate

100 mg — Tablet

Pyruvate Kinase Activator

Also known as: AQVESME

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: Oct 1, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026
via Aqvesme
Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Aqvesme
Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Local 2026
via Aqvesme
Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Care 2026
via Aqvesme
Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
BCBSNC Blue Value 2026
via Aqvesme
Tier 5 - Specialty ✓ — ✓ Limited Distribution PA | QL
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 8 hours, 2 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Aqvesme
Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Aqvesme
Not Covered — — — None
NC State Health Plan - HDHP 2026
via Aqvesme
Not Covered — — — None
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