Medicare Part D coverage · dalbavancin · RxCUI 1539243
dalbavancin 500 MG Injection
Per the CMS 2026 Part D formulary file, dalbavancin 500 MG Injection is covered by 111 Medicare Part D plans (2.2% of enrollable products), averaging Tier 3.7, with prior authorization required on 11.1% of covering formularies.
- 2.2%
- Plan coverage
- 111
- Plans covering
- T3.7
- Avg tier
- 11.1%
- Prior auth required
What the CMS Formulary Data Shows for dalbavancin 500 MG Injection
Per the CMS 2026 Part D formulary file, dalbavancin 500 MG Injection (RxNorm concept RXCUI 1539243, generic name dalbavancin) appears on 9 distinct formulary files spanning 111 Medicare Part D plan offerings - 2.2% 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 3.7.
Real-world access to dalbavancin 500 MG Injection depends on utilization management as much as tier placement: 11.1% 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 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 today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 111
- Coverage rate
- 2.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 11.1% 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
Medicare Advantage Plans (MA-PD) Covering dalbavancin 500 MG Injection
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is dalbavancin 500 MG Injection covered by Medicare Part D?
Yes, dalbavancin 500 MG Injection is covered by 111 Medicare Part D plans (2.2% of all Part D formularies).
What tier is dalbavancin 500 MG Injection on Medicare Part D plans?
dalbavancin 500 MG Injection averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does dalbavancin 500 MG Injection require prior authorization?
11.1% of Part D formularies require prior authorization for dalbavancin 500 MG Injection. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on dalbavancin 500 MG Injection?
In 2023, total Medicare Part D spending on dalbavancin 500 MG Injection was $13,677,432, covering 1,299 beneficiaries. The average spend per beneficiary was $10,529.20.
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
- Modified 24 HR metformin hydrochloride 500 MG Extended Release Oral Tablet T3.7
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- baclofen 5 MG/ML Oral Suspension T3.7
- nitrofurantoin 10 MG/ML Oral Suspension T3.7
Similar prior-authorization rate
- prednisone 1 MG Delayed Release Oral Tablet 11.1% PA
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- 24 HR morphine sulfate 120 MG Extended Release Oral Capsule 11.1% PA
- caspofungin acetate 50 MG Injection 11% PA
- nitazoxanide 500 MG Oral Tablet 11% PA