Medications
Capmatinib (Tabrecta)
A twice-daily tablet (Tabrecta) for non-small cell lung cancer that has spread and carries a MET exon 14 skipping change; it blocks the MET growth signal.
How Medicare covers it
Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.
| Coverage details | |
|---|---|
| Part B status | No capmatinib row in the CMS Part B Spending by Drug HCPCS file (RY26, data through 2024) — no J-code basis; coverage path is Part D. |
| Medicare Advantage | Most Medicare Advantage plans that include drug coverage (MAPD plans) use the same formulary-and-tier system; the plan's own drug list decides coverage and copay — check the plan's formulary. |
| Medicare Supplement (Medigap) | Medicare Supplement (Medigap) plans sold today do not include prescription drug coverage; drug coverage comes from Part D or an MAPD plan. |
What it treats
Metastatic non-small cell lung cancer (NSCLC) in adults whose tumors have a mutation that leads to MET exon 14 skipping, as detected by an FDA-approved test. Brand name Tabrecta.
What it is for, in depth
Tabrecta (capmatinib) is a targeted cancer pill for adults with metastatic non-small cell lung cancer (NSCLC) whose tumors have a mutation that leads to MET exon 14 skipping, confirmed by an FDA-approved test on tumor or blood samples. Because it only targets this specific MET change, it is prescribed for that tested subgroup of lung cancer patients rather than for lung cancer in general. The dose is 400 mg by mouth twice daily with or without food, continued until the disease progresses or side effects become unacceptable. It comes as 150 mg and 200 mg film-coated tablets, and liver tests plus pancreatic enzymes (amylase and lipase) are monitored during treatment.
How it works
It is a kinase inhibitor that targets MET, including the abnormal MET protein made when exon 14 is skipped. That missing piece removes a brake on MET signaling, so the cancer gets more growth signals; capmatinib blocks MET and its downstream signaling, which slows the growth and survival of MET-dependent cancer cells.
How it is taken
400 mg by mouth twice a day, with or without food. Swallow tablets whole; do not break, crush, or chew them. If a dose is missed or vomited, do not make it up — take the next dose at its scheduled time. Treatment is continued until the disease progresses or side effects become unacceptable, with dose reductions to 300 mg twice daily and then 200 mg twice daily if needed.
Common side effects
The most common side effects (20% or more) are swelling (edema, 59%), nausea (46%), muscle and bone pain (40%), fatigue (34%), vomiting (28%), shortness of breath (25%), cough (21%), and decreased appetite (21%). Common lab changes include decreased albumin, increased creatinine, increased liver tests (ALT, amylase, alkaline phosphatase, GGT, lipase, AST), decreased phosphate, increased potassium, decreased sodium and glucose, and decreased lymphocytes, white blood cells, and hemoglobin.
Serious warnings
Interstitial lung disease (ILD)/pneumonitis, which can be fatal — watch for new or worsening cough, shortness of breath, or fever, and Tabrecta is stopped permanently if ILD/pneumonitis occurs. Liver injury (hepatotoxicity): liver blood tests are checked before starting, every 2 weeks for the first 3 months, then monthly. Pancreatic toxicity: amylase and lipase are checked at baseline and regularly, and pancreatitis requires permanent discontinuation. Serious allergic (hypersensitivity) reactions, with fever, chills, itching, rash, low blood pressure, nausea, and vomiting. Sun sensitivity (photosensitivity) — limit direct ultraviolet exposure and use sunscreen or protective clothing. Harm to an unborn baby (embryo-fetal toxicity). Tabrecta has no boxed warning and no contraindications.
Who should be careful
People who could become pregnant, and men with partners who could become pregnant, must use effective birth control during treatment and for 1 week after the last dose. Do not breastfeed during treatment and for 1 week after the last dose. People with lung, liver, or pancreatic problems need the label's scheduled lab monitoring (liver tests and amylase/lipase), and anyone with new breathing symptoms, signs of liver problems, or signs of pancreatitis should contact their care team right away. Limit sun and ultraviolet exposure during treatment.
Major interactions
Strong CYP3A inhibitors raise capmatinib levels and may increase side effects — watch patients closely when they are used together. Strong and moderate CYP3A inducers lower capmatinib levels and may make Tabrecta work less well — avoid using them together. Tabrecta raises the levels of other drugs: CYP1A2 substrates, P-glycoprotein (P-gp) and BCRP substrates, and MATE1 and MATE2K substrates — if such a drug must be used and even small level changes could cause serious side effects, lower that drug's dose as its own label directs.
Cost and saving notes
This drug is usually covered under Medicare Part D, often through a specialty pharmacy with prior authorization. If your cost is high, ask your plan about a tier exception. If you have limited income, the Extra Help (Low-Income Subsidy) program can lower your Part D premiums and drug costs. In 2027, your total yearly out-of-pocket spending on Part D drugs is capped at $2,400, and you can ask your plan to spread those costs out in monthly payments through the Medicare Prescription Payment Plan. The maker may also offer a patient support program.
Why it is in its tier
Capmatinib (Tabrecta) sits on Tier 5 in 96.91% of the plans that list it (5325 of 5495 listing plans). Tier 5 is the specialty tier — instead of a flat copay, patients usually pay a percentage of the drug's cost (coinsurance), which is why specialty drugs feel expensive even with coverage. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $106,164 per beneficiary for 2024 — among the highest-cost drugs in the program, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.
Sources
- TABRECTA (CAPMATINIB) TABLET, FILM COATED [NOVARTIS PHARMACEUTICALS CORPORATION] — DailyMed
- MedlinePlus — National Library of Medicine
- MedlinePlus — Capmatinib
What official patient guides say
Capmatinib comes as a tablet you take by mouth twice a day, at around the same times every day. It can be taken with or without food, so you can fit the two doses around your normal meals and routine. Swallow the tablets whole — do not split, chew, or crush them — and take the medicine exactly as directed, no more or less and no more often than prescribed. Treatment continues as your doctor directs, and your doctor may pause treatment, stop it, or lower your dose depending on how well it works for you and how you feel, so be sure to tell your doctor how you are feeling. If you miss a dose, skip it and take the next dose at its scheduled time — do not take a double dose to make up for it. If you vomit after a dose, do not take another one; just continue with your regular schedule. Store capmatinib in its original container, tightly closed, at room temperature away from heat and moisture, do not remove the desiccant cartridge, and discard unused tablets 6 weeks after first opening the bottle. Keep all doctor and laboratory appointments.
Source: MedlinePlus — Capmatinib
Part D formulary coverage
| Formulary summary | |
|---|---|
| Most common tier | 5 |
| Plans listing this drug | 5495 |
| Total Part D plans | 5495 |
| Share of plans listing it | 100 |
| Formularies listing it | 286 |
| Tier | Plans |
|---|---|
| Tier 1 | 123 plans |
| Tier 2 | 1 plans |
| Tier 4 | 46 plans |
| Tier 5 | 5325 plans |
Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.
What you pay
| With Medicare Part D | |
|---|---|
| Most common tier | Tier 5 |
| Typical copay | $0 — half of plans charge between $0 and $0 |
| Typical coinsurance | 26.0% of the price |
| Based on | 5237 plans that cover this drug · 2027 plan year |
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07
Similar medications
Other medications in the same FDA pharmacologic class (Kinase Inhibitor):
Read next
Part D spending averages (2024)
| Brand name | Generic name | Total claims 2024 | Total spending 2024 | Total beneficiaries 2024 | Rank by beneficiaries 2024 |
|---|---|---|---|---|---|
| Tabrecta | Capmatinib Hydrochloride | 6477 | 1.24105e+08 | 1169 | 1748 |
Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30
Companies covering this drug
5,495 plans from 509 companies list this drug on a formulary for 2027. Search by company or plan name, or filter by tier. Cost sharing is the plan's published amount for this drug's tier in the initial coverage stage (1-month retail supply), where the plan publishes it; a blank means the plan does not publish it.
| Company | Plan | Tier | Copay | Coinsurance |
|---|
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.
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