clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel
clindamycin phosphate
RxCUI: 882548
What the CMS Formulary Data Shows for clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel (RxNorm concept RXCUI 882548, generic name clindamycin phosphate) appears on 2 distinct formulary files spanning 22 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 50% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 303,687 Part D beneficiaries filled clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $28,646,532 and an average per-beneficiary annual cost of $94.33. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 22
- Coverage rate
- 0.4%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 50% of formularies
2023 Medicare Spending
- Beneficiaries
- 303,687
- Total spending
- $28,646,532
- Avg per beneficiary
- $94.33
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T2 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T2 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel
20 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T2 | Yes | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T2 | Yes | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T2 | Yes | $145.40 | PA |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | OR |
| PacificSource Dual Care Alliance (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $19.00 | ID |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $29.10 | OR |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $88.70 | OR |
| PacificSource Medicare Essentials Rx 6 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | Yes | $105.90 | OR |
Frequently Asked Questions
Is clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel covered by Medicare Part D?
Yes, clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel is covered by 22 Medicare Part D plans (0.4% of all Part D formularies).
What tier is clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel on Medicare Part D plans?
clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.
Does clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel require prior authorization?
100% of Part D formularies require prior authorization for clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 50%.
How much does Medicare spend on clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on clindamycin phosphate 0.012 MG/MG / tretinoin 0.00025 MG/MG Topical Gel was $28,646,532, covering 303,687 beneficiaries. The average spend per beneficiary was $94.33.
Read our methodology - how this data is sourced, computed, and verified.