Medicare Part D coverage · adapalene · RxCUI 313852
adapalene 1 MG/ML Topical Cream
Per the CMS 2026 Part D formulary file, adapalene 1 MG/ML Topical Cream is covered by 480 Medicare Part D plans (9.5% of enrollable products), averaging Tier 2.7, with prior authorization required on 17.8% of covering formularies.
- 9.5%
- Plan coverage
- 480
- Plans covering
- T2.7
- Avg tier
- 17.8%
- Prior auth required
What the CMS Formulary Data Shows for adapalene 1 MG/ML Topical Cream
Per the CMS 2026 Part D formulary file, adapalene 1 MG/ML Topical Cream (RxNorm concept RXCUI 313852, generic name adapalene) appears on 73 distinct formulary files spanning 480 Medicare Part D plan offerings - 9.5% 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 2.7.
Real-world access to adapalene 1 MG/ML Topical Cream depends on utilization management as much as tier placement: 17.8% of covering formularies require prior authorization. 2.7% require step therapy. 5.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,155 Part D beneficiaries filled adapalene 1 MG/ML Topical Cream in 2023, with total plan-and-beneficiary spending of $2,842,497 and an average per-beneficiary annual cost of $684.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry adapalene 1 MG/ML Topical Cream today.
Coverage Details
- Formularies covering
- 73
- Plans covering
- 480
- Coverage rate
- 9.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 17.8% of formularies
- Step therapy required
- 2.7% of formularies
- Quantity limits
- 5.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,155
- Total spending
- $2,842,497
- Avg per beneficiary
- $684.11
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering adapalene 1 MG/ML Topical Cream
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
Show the next 30 plans
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $58.80 | NY |
| MCS Classicare RxMax (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Firme (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Hero (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Excede (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS Advantage, Inc. | T2 | Yes | $0 | PR |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| ATRIO Prime Rx (HMO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is adapalene 1 MG/ML Topical Cream covered by Medicare Part D?
Yes, adapalene 1 MG/ML Topical Cream is covered by 480 Medicare Part D plans (9.5% of all Part D formularies).
What tier is adapalene 1 MG/ML Topical Cream on Medicare Part D plans?
adapalene 1 MG/ML Topical Cream averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does adapalene 1 MG/ML Topical Cream require prior authorization?
17.8% of Part D formularies require prior authorization for adapalene 1 MG/ML Topical Cream. Step therapy: 2.7%. Quantity limits: 5.5%.
How much does Medicare spend on adapalene 1 MG/ML Topical Cream?
In 2023, total Medicare Part D spending on adapalene 1 MG/ML Topical Cream was $2,842,497, covering 4,155 beneficiaries. The average spend per beneficiary was $684.11.
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
- cyclosporine, modified 25 MG Oral Capsule T2.7
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Similar prior-authorization rate
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- {28 (estrogens, conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet) } Pack [Prempro 0.625/5 28 Day] 17.8% PA
- penicillamine 250 MG Oral Capsule 17.9% PA
- 24 HR paliperidone 9 MG Extended Release Oral Tablet 17.7% PA
- 24 HR paliperidone 3 MG Extended Release Oral Tablet 17.7% PA
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