Medications
Ceritinib (Zykadia)
An oral tablet (Zykadia) for metastatic lung cancer that carries an ALK gene change; it blocks the faulty ALK growth signal. A gene test is done before starting.
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 ceritinib 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 lung cancer that carries an ALK gene change, per the package record. The label extract provided for this package contained no sections, so no further label indication detail is stated here.
What it is for, in depth
Zykadia is a targeted oral tablet for metastatic lung cancer with an ALK gene change — it is not general chemotherapy. The package record says it blocks the faulty ALK growth signal and that a gene test is done before starting. Note for this package: the DailyMed label extract provided contained the label title and setid only, with no sections, so this entry states only what the title and package record support and does not add dosing, side effect, or warning detail from any other source.
How it works
Per the package record, ceritinib blocks the faulty ALK growth signal that drives this lung cancer. A gene test is done before starting. The label extract provided for this package contained no clinical pharmacology section.
How it is taken
Zykadia is an oral tablet, per the label title and package record. The label extract provided for this package contained no dosage section, so no dose, food rule, or schedule is stated here.
Common side effects
['The label extract provided for this package contained no adverse reactions section, so no side effects are listed here — check the full FDA label for Zykadia before use']
Serious warnings
['The label extract provided for this package contained no warnings section, so no warnings are listed here — check the full FDA label for Zykadia before use']
Who should be careful
['People whose cancer has not been tested for an ALK gene change — the package record says a gene test is done before starting', 'Anyone starting this drug — the label extract for this package was empty, so the full FDA label should be reviewed for who should be careful']
Major interactions
['The label extract provided for this package contained no drug interactions section, so no interactions are listed here — tell the prescriber about every other medicine before starting']
Cost and saving notes
Ceritinib (Zykadia) is a brand-only cancer tablet, and it sits on Tier 5, the specialty tier, in nearly every plan that lists it — so patients usually pay a percentage of the cost rather than a flat copay. Plans usually require prior authorization confirming the ALK test result. Ask about a tier exception, and check Extra Help if your income is limited. The 2027 Part D out-of-pocket cap is $2,400 for the year, and the Medicare Prescription Payment Plan can spread drug costs across the year.
Why it is in its tier
Ceritinib (Zykadia) 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 $74,619 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
- ZYKADIA (CERITINIB) TABLET, FILM COATED [NOVARTIS PHARMACEUTICALS CORPORATION] — DailyMed
- MedlinePlus — National Library of Medicine
- MedlinePlus Drug Information
What official patient guides say
Ceritinib comes as a tablet to take by mouth, usually with food once a day, at around the same time every day. If you vomit after taking ceritinib, do not take another dose; continue your regular dosing schedule. Do not eat grapefruit or drink grapefruit juice while taking this medication. If you forget a dose, take the missed dose as soon as you remember it; however, if it is within 12 hours of your next dose, skip the missed dose and continue your regular dosing schedule, and do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, stored at room temperature and away from light, excess heat and moisture (not in the bathroom). Keep all appointments with your doctor and the laboratory; your doctor will order certain lab tests to check your body's response to ceritinib, and will also order a lab test before you begin treatment to find out if your cancer can be treated with ceritinib.
Source: MedlinePlus Drug Information
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 |
|---|---|---|---|---|---|
| Zykadia | Ceritinib | 424 | 4.55174e+06 | 61 | 2896 |
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.
Care and Living Guide is not connected with or endorsed by the U.S. government or the federal Medicare program. For official information visit Medicare.gov or call 1-800-MEDICARE.