That's exactly why I take issue with JT's statement:
little over 90% of adult lives on Medicare Part D covered by insurance predominantly tier 2, predominantly unrestricted
That does not appear to be the case for your patients, and it's not true for most folks on Medicare here that take V - it's either not covered at all or it's on T4. Someone mentioned they have a $54 copay with Express Scrips, but I'm 99% sure that they added V to the formulary at a low tier (T3?) during 2019, or after the deadline for enrolling for 2019 Part D had passed, because it was not covered in my state when I was checking plans last year.