Medicare Part D coverage · 168 · RxCUI 310170
168 HR estradiol 0.00104 MG/HR Transdermal System [Climara]
Per the CMS 2026 Part D formulary file, 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] is covered by 130 Medicare Part D plans (2.6% of enrollable products), averaging Tier 3, with prior authorization required on 50% of covering formularies.
- 2.6%
- Plan coverage
- 130
- Plans covering
- T3
- Avg tier
- 50%
- Prior auth required
What the CMS Formulary Data Shows for 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara]
Per the CMS 2026 Part D formulary file, 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] (RxNorm concept RXCUI 310170, generic name 168) appears on 4 distinct formulary files spanning 130 Medicare Part D plan offerings - 2.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] depends on utilization management as much as tier placement: 50% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,601 Part D beneficiaries filled 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] in 2023, with total plan-and-beneficiary spending of $3,683,131 and an average per-beneficiary annual cost of $557.97. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 130
- Coverage rate
- 2.6%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 50% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,601
- Total spending
- $3,683,131
- Avg per beneficiary
- $557.97
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] covered by Medicare Part D?
Yes, 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] is covered by 130 Medicare Part D plans (2.6% of all Part D formularies).
What tier is 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] on Medicare Part D plans?
168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.
Does 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] require prior authorization?
50% of Part D formularies require prior authorization for 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara]?
In 2023, total Medicare Part D spending on 168 HR estradiol 0.00104 MG/HR Transdermal System [Climara] was $3,683,131, covering 6,601 beneficiaries. The average spend per beneficiary was $557.97.
Read our methodology - how this data is sourced, computed, and verified.
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Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
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