1.7 ML denosumab 70 MG/ML Injection [Xgeva]
denosumab
RxCUI: 1046402
What the CMS Formulary Data Shows for 1.7 ML denosumab 70 MG/ML Injection [Xgeva]
Per the CMS 2026 Part D formulary file, 1.7 ML denosumab 70 MG/ML Injection [Xgeva] (RxNorm concept RXCUI 1046402, generic name denosumab) appears on 93 distinct formulary files spanning 1,728 Medicare Part D plan offerings - 34.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.3.
Real-world access to 1.7 ML denosumab 70 MG/ML Injection [Xgeva] depends on utilization management as much as tier placement: 98.9% of covering formularies require prior authorization. 0% require step therapy. 26.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,900 Part D beneficiaries filled 1.7 ML denosumab 70 MG/ML Injection [Xgeva] in 2023, with total plan-and-beneficiary spending of $46,309,173 and an average per-beneficiary annual cost of $15,968.68. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1.7 ML denosumab 70 MG/ML Injection [Xgeva] today.
Coverage Details
- Formularies covering
- 93
- Plans covering
- 1,728
- Coverage rate
- 34.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 26.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,900
- Total spending
- $46,309,173
- Avg per beneficiary
- $15,968.68
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1.7 ML denosumab 70 MG/ML Injection [Xgeva]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $31.20 | MD |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | Yes | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T4 | Yes | $0 | FL |
Frequently Asked Questions
Is 1.7 ML denosumab 70 MG/ML Injection [Xgeva] covered by Medicare Part D?
Yes, 1.7 ML denosumab 70 MG/ML Injection [Xgeva] is covered by 1,728 Medicare Part D plans (34.1% of all Part D formularies).
What tier is 1.7 ML denosumab 70 MG/ML Injection [Xgeva] on Medicare Part D plans?
1.7 ML denosumab 70 MG/ML Injection [Xgeva] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1.7 ML denosumab 70 MG/ML Injection [Xgeva] require prior authorization?
98.9% of Part D formularies require prior authorization for 1.7 ML denosumab 70 MG/ML Injection [Xgeva]. Step therapy: 0%. Quantity limits: 26.9%.
How much does Medicare spend on 1.7 ML denosumab 70 MG/ML Injection [Xgeva]?
In 2023, total Medicare Part D spending on 1.7 ML denosumab 70 MG/ML Injection [Xgeva] was $46,309,173, covering 2,900 beneficiaries. The average spend per beneficiary was $15,968.68.
Read our methodology - how this data is sourced, computed, and verified.