benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
benzoyl peroxide
RxCUI: 1598470
What the CMS Formulary Data Shows for benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel (RxNorm concept RXCUI 1598470, generic name benzoyl peroxide) appears on 7 distinct formulary files spanning 27 Medicare Part D plan offerings - 0.5% 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 3.1.
Real-world access to benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 465 Part D beneficiaries filled benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $437,973 and an average per-beneficiary annual cost of $941.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 27
- Coverage rate
- 0.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 465
- Total spending
- $437,973
- Avg per beneficiary
- $941.88
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel
27 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T4 | No | $0 | MA |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T4 | No | $62.00 | MA |
| Medicare BlueEnhanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $70.30 | NY |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T4 | No | $79.70 | MA |
| Medicare BluePlus (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $86.40 | NY |
| CDPHP Clear Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $135.00 | NY |
| Medicare Blue Choice Optimum (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $146.00 | NY |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T4 | No | $147.20 | MA |
Frequently Asked Questions
Is benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel covered by Medicare Part D?
Yes, benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel is covered by 27 Medicare Part D plans (0.5% of all Part D formularies).
What tier is benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel on Medicare Part D plans?
benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel require prior authorization?
0% of Part D formularies require prior authorization for benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on benzoyl peroxide 0.0375 MG/MG / clindamycin phosphate 0.012 MG/MG Topical Gel was $437,973, covering 465 beneficiaries. The average spend per beneficiary was $941.88.
Read our methodology - how this data is sourced, computed, and verified.