Medicare Part D coverage · collagenase · RxCUI 1149617
collagenase 0.25 UNT/MG Topical Ointment [Santyl]
Per the CMS 2026 Part D formulary file, collagenase 0.25 UNT/MG Topical Ointment [Santyl] is covered by 4,985 Medicare Part D plans (98.7% of enrollable products), averaging Tier 3.2, with prior authorization required on 27.8% of covering formularies.
- 98.7%
- Plan coverage
- 4,985
- Plans covering
- T3.2
- Avg tier
- 27.8%
- Prior auth required
What the CMS Formulary Data Shows for collagenase 0.25 UNT/MG Topical Ointment [Santyl]
Per the CMS 2026 Part D formulary file, collagenase 0.25 UNT/MG Topical Ointment [Santyl] (RxNorm concept RXCUI 1149617, generic name collagenase) appears on 320 distinct formulary files spanning 4,985 Medicare Part D plan offerings - 98.7% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to collagenase 0.25 UNT/MG Topical Ointment [Santyl] depends on utilization management as much as tier placement: 27.8% of covering formularies require prior authorization. 0% require step therapy. 88.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 148,983 Part D beneficiaries filled collagenase 0.25 UNT/MG Topical Ointment [Santyl] in 2023, with total plan-and-beneficiary spending of $194,978,096 and an average per-beneficiary annual cost of $1,308.73. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry collagenase 0.25 UNT/MG Topical Ointment [Santyl] today.
Coverage Details
- Formularies covering
- 320
- Plans covering
- 4,985
- Coverage rate
- 98.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 27.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 88.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 148,983
- Total spending
- $194,978,096
- Avg per beneficiary
- $1,308.73
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering collagenase 0.25 UNT/MG Topical Ointment [Santyl]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| 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 |
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is collagenase 0.25 UNT/MG Topical Ointment [Santyl] covered by Medicare Part D?
Yes, collagenase 0.25 UNT/MG Topical Ointment [Santyl] is covered by 4,985 Medicare Part D plans (98.7% of all Part D formularies).
What tier is collagenase 0.25 UNT/MG Topical Ointment [Santyl] on Medicare Part D plans?
collagenase 0.25 UNT/MG Topical Ointment [Santyl] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does collagenase 0.25 UNT/MG Topical Ointment [Santyl] require prior authorization?
27.8% of Part D formularies require prior authorization for collagenase 0.25 UNT/MG Topical Ointment [Santyl]. Step therapy: 0%. Quantity limits: 88.8%.
How much does Medicare spend on collagenase 0.25 UNT/MG Topical Ointment [Santyl]?
In 2023, total Medicare Part D spending on collagenase 0.25 UNT/MG Topical Ointment [Santyl] was $194,978,096, covering 148,983 beneficiaries. The average spend per beneficiary was $1,308.73.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega] T3.2
- caspofungin acetate 70 MG Injection T3.2
- 2 ML penicillin G benzathine 450000 UNT/ML / penicillin G procaine 150000 UNT/ML Prefilled Syringe [Bicillin] T3.2
- 0.5 ML diazepam 5 MG/ML Rectal Gel T3.2
- phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin] T3.2
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix 4.25/5] T3.2
Similar prior-authorization rate
- dexamethasone 20 MG Oral Tablet [Hemady] 27.8% PA
- tedizolid phosphate 200 MG Injection [Sivextro] 27.9% PA
- levocarnitine 330 MG Oral Tablet 27.9% PA
- heparin sodium, porcine 20000 UNT/ML Injectable Solution 27.7% PA
- imipramine hydrochloride 10 MG Oral Tablet 27.7% PA
- imipramine hydrochloride 25 MG Oral Tablet 27.7% PA