dalbavancin 500 MG Injection [Dalvance]

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dalbavancin

RxCUI: 1539248

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.
4.5%
Plan Coverage
226
Plans Covering
T4.2
Avg Tier
9.1%
Prior Auth Required

What the CMS Formulary Data Shows for dalbavancin 500 MG Injection [Dalvance]

Per the CMS 2026 Part D formulary file, dalbavancin 500 MG Injection [Dalvance] (RxNorm concept RXCUI 1539248, generic name dalbavancin) appears on 11 distinct formulary files spanning 226 Medicare Part D plan offerings - 4.5% 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 4.2.

Real-world access to dalbavancin 500 MG Injection [Dalvance] depends on utilization management as much as tier placement: 9.1% 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 1,299 Part D beneficiaries filled dalbavancin 500 MG Injection [Dalvance] in 2023, with total plan-and-beneficiary spending of $13,677,432 and an average per-beneficiary annual cost of $10,529.20. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dalbavancin 500 MG Injection [Dalvance] today.

Coverage Details

Formularies covering
11
Plans covering
226
Coverage rate
4.5%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
9.1% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
1,299
Total spending
$13,677,432
Avg per beneficiary
$10,529.20

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
15 plans
Tier 4, Non-Preferred
82 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering dalbavancin 500 MG Injection [Dalvance]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 No $0 NV
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T4 No $0 MS
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 No $0 AZ
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 No $0 AZ
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 No $0 AZ
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 No $0 AZ
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Platinum + Instacart (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health AllCare Preferred (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Platinum + Instacart (HMO-POS) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Harmony (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Balance (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health the ONE (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health CommUnity (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health smartSavings (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Heart & Diabetes Care (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health My Choice Select (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health My Choice CalCare (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Honor+ Plan (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health ValorCare (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Heart & Diabetes Care (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health L.A. Premium Giveback (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health S.D. Premium Giveback (HMO) ALIGNMENT HEALTH PLAN T5 No $0 CA
Alignment Health Platinum (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 No $0 NC
Alignment Health NC Duals (HMO-POS D-SNP) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 No $0 NC
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 No $0 NC
Alignment Health Platinum + Instacart (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 No $0 NV
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 No $0 NV

Frequently Asked Questions

Is dalbavancin 500 MG Injection [Dalvance] covered by Medicare Part D?

Yes, dalbavancin 500 MG Injection [Dalvance] is covered by 226 Medicare Part D plans (4.5% of all Part D formularies).

What tier is dalbavancin 500 MG Injection [Dalvance] on Medicare Part D plans?

dalbavancin 500 MG Injection [Dalvance] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does dalbavancin 500 MG Injection [Dalvance] require prior authorization?

9.1% of Part D formularies require prior authorization for dalbavancin 500 MG Injection [Dalvance]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on dalbavancin 500 MG Injection [Dalvance]?

In 2023, total Medicare Part D spending on dalbavancin 500 MG Injection [Dalvance] was $13,677,432, covering 1,299 beneficiaries. The average spend per beneficiary was $10,529.20.

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