Octreotide Acetate
Generic: octreotide acetate subcutaneous
10mg, 20mg, 30mg — Injection
Also known as:
octreotide acetate kit 10mg, 20mg, 30mg; soln 50mcg/ml, 100mcg/ml, 200mcg/ml, 500mcg/ml, 1000mcg/5ml, 1000mcg/ml; sosy 50mcg/ml, 100mcg/ml, 500mcg/ml
octreotide acetate inj 50 mcg/ ml (0.05 mg/ml), 100 mcg/ ml (0.1 mg/ml), 500 mcg/ml (0.5 mg/ml)
octreotide acetate inj 200 mcg/ ml (0.2 mg/ml), 1000 mcg/ml
octreotide acetate kit 10mg, 20mg, 30mg; soln 50mcg/ml, 100mcg/ml, 200mcg/ml, 500mcg/ml, 1000mcg/5ml, 1000mcg/ml; sosy 50mcg/ml, 100mcg/ml
MYCAPSSA
octreotide acetate kit 10mg, 20mg, 30mg; soln
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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | ✓ | — | — | PA |
| BCBS Federal Basic Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
| BCBS Federal Standard Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Local 2026
via 1 Mg/Ml |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | ✓ | PA | QL |
|
BCBSNC Blue Care 2026
via 1 Mg/Ml |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | ✓ | PA | QL |
|
BCBSNC Blue Value 2026
via 1 Mg/Ml |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | ✓ | PA | QL |
|
BCBSNC Blue Advantage 2026
via 1 Mg/Ml |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | ✓ | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via 1 Mg/Ml |
Tier 2 - Medium Cost Generic/Brand | ✓ | — | ✓ | PA | QL |
|
BCBSNC Blue Local 2026
via Mycapssa |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Care 2026
via Mycapssa |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Value 2026
via Mycapssa |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
| BCBSNC Blue Advantage 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Local 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Care 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Value 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Mycapssa |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Mycapssa |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access; Limited Distribution | PA | QL |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Tier 4 - Specialty Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 4 - Specialty Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 4 - Specialty Generic | ✓ | — | ✓ | PA | QL |