Medicare Part D coverage · 72 · RxCUI 1603495
72 HR fentanyl 0.0375 MG/HR Transdermal System
Per the CMS 2026 Part D formulary file, 72 HR fentanyl 0.0375 MG/HR Transdermal System is covered by 1,887 Medicare Part D plans (37.4% of enrollable products), averaging Tier 3.1, with prior authorization required on 79% of covering formularies.
- 37.4%
- Plan coverage
- 1,887
- Plans covering
- T3.1
- Avg tier
- 79%
- Prior auth required
What the CMS Formulary Data Shows for 72 HR fentanyl 0.0375 MG/HR Transdermal System
Per the CMS 2026 Part D formulary file, 72 HR fentanyl 0.0375 MG/HR Transdermal System (RxNorm concept RXCUI 1603495, generic name 72) appears on 119 distinct formulary files spanning 1,887 Medicare Part D plan offerings - 37.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to 72 HR fentanyl 0.0375 MG/HR Transdermal System depends on utilization management as much as tier placement: 79% of covering formularies require prior authorization. 0% require step therapy. 96.6% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 72 HR fentanyl 0.0375 MG/HR Transdermal System today.
Coverage Details
- Formularies covering
- 119
- Plans covering
- 1,887
- Coverage rate
- 37.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 79% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 96.6% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 72 HR fentanyl 0.0375 MG/HR Transdermal System
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 72 HR fentanyl 0.0375 MG/HR Transdermal System covered by Medicare Part D?
Yes, 72 HR fentanyl 0.0375 MG/HR Transdermal System is covered by 1,887 Medicare Part D plans (37.4% of all Part D formularies).
What tier is 72 HR fentanyl 0.0375 MG/HR Transdermal System on Medicare Part D plans?
72 HR fentanyl 0.0375 MG/HR Transdermal System averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does 72 HR fentanyl 0.0375 MG/HR Transdermal System require prior authorization?
79% of Part D formularies require prior authorization for 72 HR fentanyl 0.0375 MG/HR Transdermal System. Step therapy: 0%. Quantity limits: 96.6%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
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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