American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra]

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American house dust mite allergenic extract

RxCUI: 1998631

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.
5.2%
Plan Coverage
262
Plans Covering
T3.1
Avg Tier
83.3%
Prior Auth Required

What the CMS Formulary Data Shows for American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra]

Per the CMS 2026 Part D formulary file, American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] (RxNorm concept RXCUI 1998631, generic name American house dust mite allergenic extract) appears on 30 distinct formulary files spanning 262 Medicare Part D plan offerings - 5.2% 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 American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] depends on utilization management as much as tier placement: 83.3% of covering formularies require prior authorization. 0% require step therapy. 70% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 493 Part D beneficiaries filled American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] in 2023, with total plan-and-beneficiary spending of $1,046,998 and an average per-beneficiary annual cost of $2,123.73. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] today.

Coverage Details

Formularies covering
30
Plans covering
262
Coverage rate
5.2%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
83.3% of formularies
Step therapy required
0% of formularies
Quantity limits
70% of formularies

2023 Medicare Spending

Beneficiaries
493
Total spending
$1,046,998
Avg per beneficiary
$2,123.73

Tier Distribution Across Plans

1 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
98 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T3 No $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T3 No $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T3 No $0 NY
eternalHealth Forever (HMO) ETERNALHEALTH, INC. T3 Yes $0 MA
eternalHealth Freedom (PPO) ETERNALHEALTH, INC. T3 Yes $0 MA
eternalHealth Give Back (PPO) ETERNALHEALTH, INC. T3 Yes $0 MA
eternalHealth Horizon (HMO) ETERNALHEALTH OF ARIZONA INC T3 Yes $0 AZ
eternalHealth Grand Give Back (HMO) ETERNALHEALTH OF ARIZONA INC T3 Yes $0 AZ
eternalHealth + Fry's Medicare Advantage (HMO) ETERNALHEALTH OF ARIZONA INC T3 Yes $0 AZ
Senior Care Plus Essential plan (HMO) HOMETOWN HEALTH PLAN, INC. T3 Yes $0 NV
Senior Care Plus Complete Plan (HMO) HOMETOWN HEALTH PLAN, INC. T3 Yes $0 NV
Renown Preferred Plan by Senior Care Plus (HMO) HOMETOWN HEALTH PLAN, INC. T3 Yes $0 NV
Senior Care Plus Extensive Duals Plan (HMO D-SNP) HOMETOWN HEALTH PLAN, INC. T3 Yes $0 NV
Senior Care Plus Enriched Duals Plan (HMO D-SNP) HOMETOWN HEALTH PLAN, INC. T3 Yes $0 NV
MyAdvocate Medicare Advantage SILVER (HMO-POS) BESHP, INC. T3 Yes $0 NE
Great Plain Medicare Advantage Gold (HMO I-SNP) SANFORD HEALTH PLAN T3 Yes $0 IA, SD
Align ChoicePlus (PPO) SANFORD HEALTH PLAN OF MINNESOTA T3 Yes $0 MN
Great Plains Medicare Advantage Gold (HMO I-SNP) GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC. T3 Yes $0 NE
Align ChoicePlus (PPO) SANFORD HEALTH PLAN T3 Yes $0 IA, SD
Align ChoicePlus (PPO) SANFORD HEALTH PLAN T3 Yes $0 ND
Great Plains Medicare Advantage Gold (HMO I-SNP) SANFORD HEALTH PLAN T3 Yes $0 ND
Align Dual Partnership (HMO D-SNP) SANFORD HEALTH PLAN T3 Yes $0 ND
Ally Rx (HMO D-SNP) SECURITY HEALTH PLAN OF WISCONSIN, INC. T3 Yes $0 WI
Esteem Rx (HMO-POS) SECURITY HEALTH PLAN OF WISCONSIN, INC. T3 Yes $0 WI
BlueCross Total Value (PPO) BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA T3 Yes $0 SC
BlueCross Total Value (PPO) BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA T3 Yes $0 SC
BlueCross Total Value (PPO) BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA T3 Yes $0 SC
Blue Best Life Classic (HMO) MEDISUN, INC. T3 Yes $0 AZ
Blue Best Life Classic (HMO) MEDISUN, INC. T3 Yes $0 AZ
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T3 Yes $0 MA
HealthTeam Advantage Plan I (PPO) CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA T3 Yes $0 NC
HealthTeam Advantage Vitality Plan (PPO) CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA T3 Yes $0 NC
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA T3 Yes $0 NC
AlohaCare Advantage Plus (HMO D-SNP) ALOHACARE T3 Yes $0 HI
Clear Spring Health BrightPath Advantage (HMO) CLEAR SPRING HEALTH COMMUNITY CARE, INC. T3 Yes $0 IL
Clear Spring Health BrightPath Advantage (HMO) CLEAR SPRING HEALTH OF ILLINOIS, INC. T3 Yes $0 IL
Clear Spring Health BrightPath Advantage (HMO) CLEAR SPRING HEALTH OF ILLINOIS, INC. T3 Yes $0 IL
Clear Spring Health Balance+ Diabetes & Heart (HMO C-SNP) CLEAR SPRING HEALTH OF ILLINOIS, INC. T3 Yes $0 IL
Clear Spring Health Balance+ Diabetes & Heart (HMO C-SNP) CLEAR SPRING HEALTH OF ILLINOIS, INC. T3 Yes $0 IL
Clear Spring Health BrightPath Advantage (HMO) CLEAR SPRING HEALTH (CO), INC. T3 Yes $0 CO
Clear Spring Health Balance+ Diabetes & Heart (HMO C-SNP) CLEAR SPRING HEALTH (CO), INC. T3 Yes $0 CO
Clear Spring Health Balance+ Diabetes & Heart (HMO C-SNP) CLEAR SPRING HEALTH (GA), INC. T3 Yes $0 GA
Clear Spring Health BrightPath Advantage (HMO) CLEAR SPRING HEALTH (GA), INC. T3 Yes $0 GA

Frequently Asked Questions

Is American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] covered by Medicare Part D?

Yes, American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] is covered by 262 Medicare Part D plans (5.2% of all Part D formularies).

What tier is American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] on Medicare Part D plans?

American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] require prior authorization?

83.3% of Part D formularies require prior authorization for American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra]. Step therapy: 0%. Quantity limits: 70%.

How much does Medicare spend on American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra]?

In 2023, total Medicare Part D spending on American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] was $1,046,998, covering 493 beneficiaries. The average spend per beneficiary was $2,123.73.

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