adapalene 1 MG/ML Topical Cream
adapalene
RxCUI: 313852
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 481 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 $2,863,677 and an average per-beneficiary annual cost of $689.21. 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
- 481
- 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
- $2,863,677
- Avg per beneficiary
- $689.21
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 |
| 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 |
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 481 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 $2,863,677, covering 4,155 beneficiaries. The average spend per beneficiary was $689.21.
Read our methodology - how this data is sourced, computed, and verified.