dapsone 0.05 MG/MG Topical Gel

Verify with CMS →

dapsone

RxCUI: 607295

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.
13.3%
Plan Coverage
674
Plans Covering
T3.8
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for dapsone 0.05 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, dapsone 0.05 MG/MG Topical Gel (RxNorm concept RXCUI 607295, generic name dapsone) appears on 12 distinct formulary files spanning 674 Medicare Part D plan offerings - 13.3% 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 3.8.

Real-world access to dapsone 0.05 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 16.7% require step therapy. 50% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 25,257 Part D beneficiaries filled dapsone 0.05 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $9,613,959 and an average per-beneficiary annual cost of $380.65. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dapsone 0.05 MG/MG Topical Gel today.

Coverage Details

Formularies covering
12
Plans covering
674
Coverage rate
13.3%
Tier range
Tier 2 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
16.7% of formularies
Quantity limits
50% of formularies

2023 Medicare Spending

Beneficiaries
25,257
Total spending
$9,613,959
Avg per beneficiary
$380.65

Tier Distribution Across Plans

1 plans
Tier 2, Generic
14 plans
Tier 3, Preferred Brand
85 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering dapsone 0.05 MG/MG Topical Gel

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

Plan Insurer Tier PA Premium States
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T3 No $0 NV
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T4 No $0 CA
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare HIDE (HMO D-SNP) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare Dual Care (HMO D-SNP) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T4 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T4 No $0 OH
Aetna Medicare Signature (HMO) AETNA HEALTH INC.(GA) T4 No $0 GA
Aetna Medicare Signature (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T4 No $0 WI
Aetna Medicare Signature (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T4 No $0 IL
Aetna Medicare Prime Chronic Care (HMO C-SNP) COVENTRY HEALTH CARE OF ILLINOIS, INC. T4 No $0 IL
Aetna Medicare Signature Extra (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T4 No $0 IL
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 IA
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 NE
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 KS, MO
Aetna Medicare Signature Extra (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 KS
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 KS, MO
Aetna Medicare Signature Plus (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T4 No $0 AR

Frequently Asked Questions

Is dapsone 0.05 MG/MG Topical Gel covered by Medicare Part D?

Yes, dapsone 0.05 MG/MG Topical Gel is covered by 674 Medicare Part D plans (13.3% of all Part D formularies).

What tier is dapsone 0.05 MG/MG Topical Gel on Medicare Part D plans?

dapsone 0.05 MG/MG Topical Gel averages Tier 3.8 across Part D plans, ranging from Tier 2 to Tier 4.

Does dapsone 0.05 MG/MG Topical Gel require prior authorization?

0% of Part D formularies require prior authorization for dapsone 0.05 MG/MG Topical Gel. Step therapy: 16.7%. Quantity limits: 50%.

How much does Medicare spend on dapsone 0.05 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on dapsone 0.05 MG/MG Topical Gel was $9,613,959, covering 25,257 beneficiaries. The average spend per beneficiary was $380.65.

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