GEMTESA: cost and payments to doctors
What Medicare Part D paid pharmacies for GEMTESA, and the payments that named it as the associated drug or biological under the Sunshine Act for program years 2019–2025.
What GEMTESA costs under Medicare Part D
This is what Part D plans and patients paid pharmacies — not what you would pay, and not money the prescriber received. Your own cost depends on your plan and where you are in your benefit year. It excludes commercial insurance, Medicaid and Part B, and it is before the manufacturer rebates CMS does not publish.
The comparable unit
A year of therapy, if taken monthly
With 11+ claims; CMS suppresses fewer
- Active ingredient
- Vibegron
- Claims (published)
- 1,195,468
- 30-day fills
- 1,823,388
- Total paid to pharmacies
- $811,538,652
Most prescribed by urology, nurse practitioner, physician assistant.
Source: CMS Medicare Part D Prescribers — by Provider and Drug. Totals cover rows CMS published; prescriber-drug pairs with fewer than 11 claims are suppressed and are not counted here.
Was your doctor paid by Sumitomo Pharma America, Inc.?
Sumitomo Pharma America, Inc. reported the most payments naming GEMTESA. Search your clinician to see whether they are among them — and what else they were paid for.
Finding a payment is not a finding of wrongdoing — most reported payments are a meal during a presentation. What matters is the kind, the size, and how it compares with their peers, which is what the profile shows.
- Total reported
- $8.2M
- Providers
- 44,887
- Transactions
- 237,061
- Average per transaction
- $35
The per-transaction average — $35 — is the number that tells you what kind of spending this is. A few dollars means meals at product presentations, reported by the thousand. Hundreds or thousands means consulting, speaking or royalty arrangements with a much smaller group of physicians. Across all 44,887 providers the average total is $184, but that average hides a very steep distribution.
Companies reporting these payments
| Company | Total reported | Share |
|---|---|---|
| Sumitomo Pharma America, Inc. | $5,598,029 | 67.9% |
| Urovant Sciences Inc | $2,226,302 | 27.0% |
| Sunovion Pharmaceuticals Inc. | $424,652 | 5.1% |
Other products from Sumitomo Pharma America, Inc.
The company that reported the most payments naming GEMTESA also reports against these.