birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez]
birch triterpenes
RxCUI: 2675592
What the CMS Formulary Data Shows for birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez]
Per the CMS 2026 Part D formulary file, birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] (RxNorm concept RXCUI 2675592, generic name birch triterpenes) appears on 12 distinct formulary files spanning 115 Medicare Part D plan offerings - 2.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.4.
Real-world access to birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 33.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 115
- Coverage rate
- 2.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 33.3% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T5 | Yes | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Complete Blue HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T5 | Yes | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T5 | Yes | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK BCBSD INC. | T5 | Yes | $0 | DE |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T5 | Yes | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T5 | Yes | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T5 | Yes | $0 | MI |
Frequently Asked Questions
Is birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] covered by Medicare Part D?
Yes, birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] is covered by 115 Medicare Part D plans (2.3% of all Part D formularies).
What tier is birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] on Medicare Part D plans?
birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez] require prior authorization?
100% of Part D formularies require prior authorization for birch triterpenes 0.1 MG/MG Topical Gel [Filsuvez]. Step therapy: 0%. Quantity limits: 33.3%.
Read our methodology - how this data is sourced, computed, and verified.