dapsone 0.075 MG/MG Topical Gel

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dapsone

RxCUI: 1741905

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.
0.8%
Plan Coverage
39
Plans Covering
T4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for dapsone 0.075 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, dapsone 0.075 MG/MG Topical Gel (RxNorm concept RXCUI 1741905, generic name dapsone) appears on 5 distinct formulary files spanning 39 Medicare Part D plan offerings - 0.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to dapsone 0.075 MG/MG Topical Gel depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 20% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 25,257 Part D beneficiaries filled dapsone 0.075 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 0.075 MG/MG Topical Gel today.

Coverage Details

Formularies covering
5
Plans covering
39
Coverage rate
0.8%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
20% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

39 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering dapsone 0.075 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 T4 No No $164.80 -
Blue Rx PDP Plus (PDP) HM HEALTH INSURANCE COMPANY T4 No No $193.20 -

Medicare Advantage Plans (MA-PD) Covering dapsone 0.075 MG/MG Topical Gel

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

Plan Insurer Tier PA Premium States
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
CDPHP $0 Medicare Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $0 NY
Network Health Cares (PPO D-SNP) NETWORK HEALTH INSURANCE CORPORATION T4 No $21.10 WI
Univera SeniorChoice Core (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $33.00 NY
Univera SeniorChoice Advanced (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $36.90 NY
Network Health PlusRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $38.60 WI
Medicare BlueClassic (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $51.00 NY
Security Blue HMO-POS Standard (HMO-POS) HIGHMARK CHOICE COMPANY T4 No $51.80 PA
Univera SeniorChoice Secure (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $54.90 NY
Medicare BlueBalanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Medicare Blue Choice Prime (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Univera SeniorChoice Value Plus (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $58.60 NY
Medicare BlueEnhanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $70.30 NY
Medicare BluePlus (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $86.40 NY
Network Health PremierRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $92.80 WI
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $95.70 PA
Security Blue HMO-POS Deluxe (HMO-POS) HIGHMARK CHOICE COMPANY T4 No $95.90 PA
Freedom Blue PPO Standard (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $98.20 PA
CDPHP Clear Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $100.00 NY
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $115.70 PA
Freedom Blue PPO Deluxe (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $122.40 PA
CDPHP Choice Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $135.00 NY
Freedom Blue PPO Classic (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $140.90 PA
Freedom Blue PPO Classic (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $145.40 PA
Medicare Blue Choice Optimum (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $146.00 NY

Frequently Asked Questions

Is dapsone 0.075 MG/MG Topical Gel covered by Medicare Part D?

Yes, dapsone 0.075 MG/MG Topical Gel is covered by 39 Medicare Part D plans (0.8% of all Part D formularies).

What tier is dapsone 0.075 MG/MG Topical Gel on Medicare Part D plans?

dapsone 0.075 MG/MG Topical Gel averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does dapsone 0.075 MG/MG Topical Gel require prior authorization?

0% of Part D formularies require prior authorization for dapsone 0.075 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 20%.

How much does Medicare spend on dapsone 0.075 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on dapsone 0.075 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