acyclovir 0.05 MG/MG Topical Ointment [Zovirax]

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acyclovir

RxCUI: 209977

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
0%
Plan Coverage
2
Plans Covering
T1
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for acyclovir 0.05 MG/MG Topical Ointment [Zovirax]

Per the CMS 2026 Part D formulary file, acyclovir 0.05 MG/MG Topical Ointment [Zovirax] (RxNorm concept RXCUI 209977, generic name acyclovir) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to acyclovir 0.05 MG/MG Topical Ointment [Zovirax] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 670,065 Part D beneficiaries filled acyclovir 0.05 MG/MG Topical Ointment [Zovirax] in 2023, with total plan-and-beneficiary spending of $49,440,237 and an average per-beneficiary annual cost of $73.78. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry acyclovir 0.05 MG/MG Topical Ointment [Zovirax] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
670,065
Total spending
$49,440,237
Avg per beneficiary
$73.78

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering acyclovir 0.05 MG/MG Topical Ointment [Zovirax]

2 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
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY

Frequently Asked Questions

Is acyclovir 0.05 MG/MG Topical Ointment [Zovirax] covered by Medicare Part D?

Yes, acyclovir 0.05 MG/MG Topical Ointment [Zovirax] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is acyclovir 0.05 MG/MG Topical Ointment [Zovirax] on Medicare Part D plans?

acyclovir 0.05 MG/MG Topical Ointment [Zovirax] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does acyclovir 0.05 MG/MG Topical Ointment [Zovirax] require prior authorization?

100% of Part D formularies require prior authorization for acyclovir 0.05 MG/MG Topical Ointment [Zovirax]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on acyclovir 0.05 MG/MG Topical Ointment [Zovirax]?

In 2023, total Medicare Part D spending on acyclovir 0.05 MG/MG Topical Ointment [Zovirax] was $49,440,237, covering 670,065 beneficiaries. The average spend per beneficiary was $73.78.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial